Study Links Certain Long COVID Symptoms to Disruptions in Cholinergic Neurotransmission
Nikhil Prasad Fact checked by:Thailand Medical News Team Feb 27, 2025 1 month, 3 days, 13 hours, 42 minutes ago
Medical News: Scientists Uncover Potential Mechanism Behind Long COVID
A groundbreaking study by researchers from the University of Leipzig Medical Centre, Helios Clinics in Germany, and Comillas University in Spain suggests that disruptions in cholinergic neurotransmission may be responsible for some of the symptoms seen in long COVID patients. The research highlights the role of nicotinic acetylcholine receptors (nAChRs) in the disorder and explores how nicotine may play a role in alleviating symptoms.
Study Links Certain Long COVID Symptoms to Disruptions in Cholinergic Neurotransmission
Understanding Cholinergic Neurotransmission and Long COVID
Since the onset of the COVID-19 pandemic, millions of people worldwide have reported experiencing long COVID - a condition marked by persistent symptoms such as fatigue, brain fog, shortness of breath, and autonomic dysfunction. The precise cause of long COVID remains unclear, but researchers have increasingly turned their attention to the cholinergic system, which plays a vital role in the nervous system and overall body function.
This
Medical News report delves into a recent review and case study conducted by the European research team, which suggests that disruptions in cholinergic neurotransmission may be a major factor in long COVID. Their findings indicate that the SARS-CoV-2 spike protein binds to nAChRs, interfering with the normal function of these receptors, which in turn leads to a wide array of symptoms.
Study Findings and the Role of Nicotine
The research team reviewed existing literature on the effects of viral interference with nAChRs and the potential for nicotine to counteract these effects. Nicotine, a known agonist of nAChRs, has the ability to bind to these receptors, potentially displacing the viral proteins that impair their function.
In an innovative case study, researchers used whole-body positron emission tomography (PET) imaging with (-)-[18F]Flubatine to assess cholinergic dysfunction in a long COVID patient. The patient, a 44-year-old woman suffering from neurological symptoms for over three years, underwent low-dose transcutaneous nicotine (LDTN) therapy. Before the treatment, PET imaging revealed reduced availability of α4β2 nAChRs in the brain. After ten days of LDTN therapy, imaging showed a 7.6% increase in receptor availability, correlating with significant clinical improvement.
A survey conducted on 231 individuals who used LDTN to manage their long COVID symptoms also supported these findings. Approximately 73.5% of respondents reported noticeable improvements, further strengthening the hypothesis that impaired cholinergic neurotransmission plays a role in the disorder.
Implications for Other Post-Viral Syndromes
The study also explored the possibility that cholinergic dysfunction may contribute to other post-viral syndromes, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-vaccination syndrome (PVS). Many of these cond
itions share overlapping symptoms with long COVID, suggesting a common underlying mechanism related to neurotransmission impairments.
Furthermore, the researchers hypothesized that the SARS-CoV-2 spike protein’s ability to bind to nAChRs may be similar to the effects of certain neurotoxins found in snake venom. This discovery raises important questions about how viral infections might trigger autoimmune responses or prolonged neurological dysfunction.
Potential for Nicotine-Based Therapies
Given the promising results of LDTN therapy, the researchers suggested that nicotine could be a viable treatment option for some long COVID patients. However, they emphasized that further research is needed to fully understand the long-term effects and optimal dosages. They also noted that nicotine therapy should only be considered under medical supervision, as nicotine carries its own risks.
Additionally, the study pointed out that other cholinergic-enhancing strategies, such as vagus nerve stimulation (VNS), might also help improve symptoms in affected patients. Non-invasive approaches like auricular vagus nerve stimulation and coherent breathing exercises could potentially augment the benefits of nicotine therapy.
Conclusions
The study presents compelling evidence that disruptions in cholinergic neurotransmission could be a key factor behind long COVID symptoms. By demonstrating how the SARS-CoV-2 spike protein may interfere with nAChRs and how nicotine may help restore receptor function, the research opens the door to potential new treatments for long COVID and other post-viral syndromes.
While nicotine therapy showed promising results, the researchers caution that more studies are necessary to establish its long-term safety and effectiveness. Nevertheless, their findings provide valuable insights that could help reshape our understanding of long COVID and offer new hope for patients struggling with its debilitating effects.
The study findings were published in the peer-reviewed journal: Bioelectronic Medicine.
https://link.springer.com/article/10.1186/s42234-025-00167-8
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