{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:01:10Z","timestamp":1793304070264,"version":"4.5.0"},"reference-count":275,"publisher":"Portland Press Ltd.","issue":"4","license":[{"start":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2,25]]},"abstract":"<jats:p>Post-acute sequelae of COVID (PASC), usually referred to as \u2018Long COVID\u2019 (a phenotype of COVID-19), is a relatively frequent consequence of SARS-CoV-2 infection, in which symptoms such as breathlessness, fatigue, \u2018brain fog\u2019, tissue damage, inflammation, and coagulopathies (dysfunctions of the blood coagulation system) persist long after the initial infection. It bears similarities to other post-viral syndromes, and to myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS). Many regulatory health bodies still do not recognize this syndrome as a separate disease entity, and refer to it under the broad terminology of \u2018COVID\u2019, although its demographics are quite different from those of acute COVID-19. A few years ago, we discovered that fibrinogen in blood can clot into an anomalous \u2018amyloid\u2019 form of fibrin that (like other \u03b2-rich amyloids and prions) is relatively resistant to proteolysis (fibrinolysis). The result, as is strongly manifested in platelet-poor plasma (PPP) of individuals with Long COVID, is extensive fibrin amyloid microclots that can persist, can entrap other proteins, and that may lead to the production of various autoantibodies. These microclots are more-or-less easily measured in PPP with the stain thioflavin T and a simple fluorescence microscope. Although the symptoms of Long COVID are multifarious, we here argue that the ability of these fibrin amyloid microclots (fibrinaloids) to block up capillaries, and thus to limit the passage of red blood cells and hence O2 exchange, can actually underpin the majority of these symptoms. Consistent with this, in a preliminary report, it has been shown that suitable and closely monitored \u2018triple\u2019 anticoagulant therapy that leads to the removal of the microclots also removes the other symptoms. Fibrin amyloid microclots represent a novel and potentially important target for both the understanding and treatment of Long COVID and related disorders.<\/jats:p>","DOI":"10.1042\/bcj20220016","type":"journal-article","created":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T07:14:34Z","timestamp":1645600474000},"page":"537-559","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":273,"title":["A central role for amyloid fibrin microclots in long COVID\/PASC: origins and therapeutic implications"],"prefix":"10.1042","volume":"479","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5838-7963","authenticated-orcid":false,"given":"Douglas B.","family":"Kell","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7ZB, U.K."},{"name":"The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Kemitorvet 200, 2800 Kgs Lyngby, Denmark"},{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch Private Bag X1 Matieland, 7602, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert Jacobus","family":"Laubscher","sequence":"additional","affiliation":[{"name":"Mediclinic Stellenbosch, Stellenbosch 7600, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9108-2384","authenticated-orcid":false,"given":"Etheresia","family":"Pretorius","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch Private Bag X1 Matieland, 7602, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2022,2,23]]},"reference":[{"key":"2022022512534956300_BCJ-2022-0016CC1","doi-asserted-by":"publisher","first-page":"698169","DOI":"10.3389\/fmicb.2021.698169","article-title":"Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms","volume":"12","year":"2021","journal-title":"Front. 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