The DOI matches its Crossref record; 98 of the 98 references it cites were found in a registry or an index.
Serotonin reduction in post-acute sequelae of viral infection
Open accessAbstract
Post-acute sequelae of COVID-19 (PASC, "Long COVID") pose a significant global health challenge. The pathophysiology is unknown, and no effective treatments have been found to date. Several hypotheses have been formulated to explain the etiology of PASC, including viral persistence, chronic inflammation, hypercoagulability, and autonomic dysfunction. Here, we propose a mechanism that links all four hypotheses in a single pathway and provides actionable insights for therapeutic interventions. We find that PASC are associated with serotonin reduction. Viral infection and type I interferon-driven inflammation reduce serotonin through three mechanisms: diminished intestinal absorption of the serotonin precursor tryptophan; platelet hyperactivation and thrombocytopenia, which impacts serotonin storage; and enhanced MAO-mediated serotonin turnover. Peripheral serotonin reduction, in turn, impedes the activity of the vagus nerve and thereby impairs hippocampal responses and memory. These findings provide a possible explanation for neurocognitive symptoms associated with viral persistence in Long COVID, which may extend to other post-viral syndromes.
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Cites
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Comprehensive Integration of Single-Cell Data
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Long COVID: major findings, mechanisms and recommendations
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Cited by
Long COVID science, research and policy
Al-Aly, Z., Davis, H., McCorkell, L., Soares, L., Wulf-Hanson, S., Iwasaki, A., & Topol, E. J. (2024) · Nature Medicine · doi:10.1038/s41591-024-03173-6 · Cited by 538
Mechanisms of long COVID and the path toward therapeutics
Peluso, M. J., & Deeks, S. G. (2024) · Cell · doi:10.1016/j.cell.2024.07.054 · Cited by 341
Self-citationMicrobiota–neuroepithelial signalling across the gut–brain axis
Ohara, T. E., & Hsiao, E. Y. (2025) · Nature Reviews Microbiology · doi:10.1038/s41579-024-01136-9 · Cited by 147
The neurobiology of SARS-CoV-2 infection
Meinhardt, J., Streit, S., Dittmayer, C., Manitius, R. V., Radbruch, H., & Heppner, F. L. (2024) · Nature Reviews Neuroscience · doi:10.1038/s41583-023-00769-8 · Cited by 64
Relationships between Brain Activity, Tryptophan-Related Gut Metabolites, and Autism Symptomatology
Aziz-Zadeh, L., Ringold, S. M., Jayashankar, A., Kilroy, E., Butera, C., Jacobs, J. P., Tanartkit, S., Mahurkar-Joshi, S., Bhatt, R. R., Dapretto, M., et al. (2025) · Nature Communications · doi:10.1038/s41467-025-58459-1 · Cited by 51
Metadata
- Authors
- Wong, A. C., Devason, A. S., Umana, I. C., Cox, T. O., Dohnalová, L., Litichevskiy, L., Perla, J., Lundgren, P., Etwebi, Z., Izzo, L. T., Kim, J., Tetlak, M., Descamps, H. C., Park, S. L., Wisser, S., McKnight, A. D., Pardy, R. D., Kim, J., Blank, N., Patel, S., Thum, K., Mason, S., Beltra, J.-C., Michieletto, M. F., Ngiow, S. F., Miller, B. M., Liou, M. J., Madhu, B., Dmitrieva-Posocco, O., Huber, A. S., Hewins, P., Petucci, C., Chu, C. P., Baraniecki-Zwil, G., Giron, L. B., Baxter, A. E., Greenplate, A. R., Kearns, C., Montone, K., Litzky, L. A., Feldman, M., Henao-Mejia, J., Striepen, B., Ramage, H., Jurado, K. A., Wellen, K. E., O’Doherty, U., Abdel-Mohsen, M., Landay, A. L., Keshavarzian, A., Henrich, T. J., Deeks, S. G., Peluso, M. J., Meyer, N. J., Wherry, E. J., Abramoff, B. A., Cherry, S., Thaiss, C. A., & Levy, M.
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2023-10
- Volume
- 186
- Issue
- 22
- Pages
- 4851-4867.e20
- ISSN
- 0092-8674 (ISSN-L)
- OpenAlex
- W4387675488
- Cited by
- 357
- References
- 98
- FWCI
- 52.74
- Type
- journal article
- Language
- en
- Open access
- hybrid
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- Wong, A. C., Devason, A. S., Umana, I. C., Cox, T. O., Dohnalová, L., Litichevskiy, L., Perla, J., Lundgren, P., Etwebi, Z., Izzo, L. T., Kim, J., Tetlak, M., Descamps, H. C., Park, S. L., Wisser, S., McKnight, A. D., Pardy, R. D., Kim, J., Blank, N., . . . Levy, M. (2023). Serotonin reduction in post-acute sequelae of viral infection. Cell. https://doi.org/10.1016/j.cell.2023.09.013
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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