{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T21:27:21Z","timestamp":1793914041830,"version":"4.8.0"},"reference-count":171,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Research, Innovation and Digitization under the Romania\u2019s National Recovery and Resilience Plan Funded by the EU\u2019s NextGenerationEU program","award":["760073\/23.05.2023"],"award-info":[{"award-number":["760073\/23.05.2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Long COVID, also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent multi-systemic symptoms such as fatigue, cognitive impairment, and respiratory dysfunction. Accumulating evidence indicates that gut and oral microbiota play an important role in its pathogenesis. Patients with long COVID consistently exhibit reduced microbial diversity, depletion of beneficial short-chain fatty acid (SCFA)-producing species such as Faecalibacterium prausnitzii and Bifidobacterium spp. and enrichment of proinflammatory taxa including Ruminococcus gnavus, Bacteroides vulgatus, and Veillonella. These alterations may disrupt intestinal barrier integrity, sustain low-grade systemic inflammation, and influence host immune and neuroendocrine pathways through the gut\u2013brain and gut\u2013lung axes. Distinct microbial signatures have also been associated with symptom clusters, including neuropsychiatric, respiratory, and gastrointestinal manifestations. Proposed mechanisms linking dysbiosis to long COVID include impaired SCFA metabolism, tryptophan depletion, microbial translocation, and interactions with host immune and inflammatory responses, including autoantibody formation and viral antigen persistence. Preliminary interventional studies using probiotics, synbiotics, and fecal microbiota transplantation suggest that microbiome-targeted therapies may alleviate symptoms, although evidence remains limited and heterogeneous. This review synthesizes current literature on the role of gut and oral microbiota in long COVID, highlights emerging microbial biomarkers, and discusses therapeutic implications. While causality remains to be firmly established, restoring microbial balance represents a promising avenue for diagnosis, prevention, and management of long COVID.<\/jats:p>","DOI":"10.3390\/ijms262010120","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:07:22Z","timestamp":1760706442000},"page":"10120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Microbiome and Long COVID-19: Current Evidence and Insights"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2274-6439","authenticated-orcid":false,"given":"Olga A.","family":"Caliman-Sturdza","sequence":"first","affiliation":[{"name":"College of Medicine and Biological Science, Stefan cel Mare University of Suceava, 720229 Suceava, Romania"},{"name":"Emergency Clinical Hospital Suceava, 720224 Suceava, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevag","family":"Hamamah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Scripps Mercy Hospital, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4626-2901","authenticated-orcid":false,"given":"Oana C.","family":"Iatcu","sequence":"additional","affiliation":[{"name":"College of Medicine and Biological Science, Stefan cel Mare University of Suceava, 720229 Suceava, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Lobiuc","sequence":"additional","affiliation":[{"name":"College of Medicine and Biological Science, Stefan cel Mare University of Suceava, 720229 Suceava, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Bosancu","sequence":"additional","affiliation":[{"name":"College of Medicine and Biological Science, Stefan cel Mare University of Suceava, 720229 Suceava, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-4457","authenticated-orcid":false,"given":"Mihai","family":"Covasa","sequence":"additional","affiliation":[{"name":"College of Medicine and Biological Science, Stefan cel Mare University of Suceava, 720229 Suceava, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e946512","DOI":"10.12659\/MSM.946512","article-title":"Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) and the Urgent Need to Identify Diagnostic Biomarkers and Risk Factors","volume":"30","author":"Parums","year":"2024","journal-title":"Med. 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