Microglia dysfunction, neurovascular inflammation and focal neuropathologies are linked to IL-1- and IL-6-related systemic inflammation in COVID-19
Fekete, R., Simats, A., Bíró, E., Pósfai, B., Cserép, C., Schwarcz, A., Szabadits, E., Környei, Z., Tóth, K., Fichó, E., Szalma, J., Vida, S., Kellermayer, A., Dávid, C., Acsády, L., Kontra, L., Silvestre-Roig, C., Moldvay, J., … Dénes, Á. (2025). Microglia dysfunction, neurovascular inflammation and focal neuropathologies are linked to IL-1- and IL-6-related systemic inflammation in COVID-19. Nature Neuroscience, 28(3), 558–576. DOI: 10.1038/s41593-025-01871-z
- Neuropathological findings show microglial dysfunction, astrocyte activation, and neurovascular inflammation, driven by systemic immune signaling (IL-1, IL-6), even without direct viral invasion.
- Evidence of blood–brain barrier disruption and gliovascular pathology, supporting ongoing brain inflammation.
- Findings suggest self-sustaining inflammatory loops between the immune system and the brain, contributing to persistent symptoms.
- Clinical observations show improvement with H1/H2 antihistamines, supporting a role for mast cell activation in symptom persistence.
- Overall, the research points toward immune dysregulation, rather than viral persistence, as a key driver in a subset of Long COVID cases.