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Erythroid-hormonal axis in long COVID.

Shokrollah Elahi¹

¹Division of Foundational Sciences, Mike Petryk School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Women and Children Health Research Institute, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Cancer Research Institute of Northern Alberta, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Glycomics Institute of Alberta, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, Alberta T6G 2E1, Canada.

Trends in Molecular Medicine

|May 5, 2026

Summary

Long COVID might stem from impaired physiological recovery, not persistent infection. Key mechanisms involve inflammation disrupting red blood cell production and hormone balance, offering new therapeutic targets.

Keywords:

CD71(+) erythroid cells ME/CFS sex hormones

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Area of Science:

Immunology
Endocrinology
Hematology

Background:

Long COVID symptoms may arise from dysregulated physiological recovery processes.
Emerging evidence suggests inflammation plays a critical role in persistent Long COVID symptoms.

Purpose of the Study:

To explore the role of erythroid-endocrine pathways in Long COVID.
To identify potential therapeutic targets for Long COVID recovery.

Main Methods:

Review of emerging evidence on Long COVID pathophysiology.
Analysis of the link between immune dysregulation, metabolic stress, and hormonal imbalance.

Main Results:

Inflammation-driven disruption of erythropoiesis (red blood cell production) is implicated.
Hormonal imbalance is identified as a central mechanism in Long COVID.

Conclusions:

Erythroid-endocrine pathways are crucial for Long COVID recovery.
Targeting these pathways may offer novel therapeutic strategies for Long COVID.