Publication date: Sep 15, 2026
The mechanisms driving the broad spectrum of Long COVID symptoms-such as fatigue, brain fog, pain, and dysautonomia-remain uncertain. This study investigated central sensitization (CS) as a potential contributor to symptom burden in patients with Long COVID. We aimed to examine its association with symptom severity, as well as objective cerebrovascular, autonomic, and inflammatory markers. A total of 169 consecutive patients with Long COVID referred for evaluation of orthostatic intolerance underwent assessment using the Central Sensitization Inventory, symptom burden surveys (autonomic: COMPASS-31; sensory: NTSS-6; global health: PROMIS), autonomic function testing (deep breathing, the Valsalva maneuver and head-up tilt test with transcranial Doppler and capnography monitoring), and skin biopsies for small-fiber assessment. CS was present in 81% of participants. Patients with CS were more often female (79. 6% vs. 53. 1%, p = 0. 004) and had higher rates of anxiety, depression, fibromyalgia and headaches, as well as a significantly greater autonomic, sensory and global health symptom burden (all p
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | long COVID |
| disease | MESH | neuroinflammation |
| disease | MESH | fatigue |
| disease | MESH | brain fog |
| disease | MESH | pain |
| disease | MESH | dysautonomia |
| disease | MESH | orthostatic intolerance |
| disease | MESH | anxiety |
| disease | MESH | fibromyalgia |
| disease | MESH | headaches |
| disease | MESH | syndrome |
| disease | MESH | Coronavirus Infections |
| disease | MESH | COVID-19 |