Kell, Douglas B, Laubscher, Gert Jacobus, Pretorius, Etheresia · The Biochemical journal · 2022 · DOI
This study suggests that Long COVID may be caused by unusual blood clots called 'fibrin amyloid microclots' that form after COVID-19 infection. These tiny clots may block small blood vessels and reduce oxygen delivery throughout the body, which could explain many Long COVID symptoms like fatigue, brain fog, and breathing problems. The researchers found these microclots in Long COVID patients' blood and propose that special blood-thinning treatments might help dissolve them and relieve symptoms.
This research provides a potential unifying biological mechanism for Long COVID and related post-viral syndromes like ME/CFS, which have historically lacked clear pathophysiological explanations. If microclots are validated as a central driver, it could transform diagnostic and therapeutic approaches for millions of patients whose symptoms remain unexplained by conventional medicine. Understanding shared mechanisms between Long COVID and ME/CFS may accelerate progress in both conditions.
This study does not prove that microclots cause Long COVID—it presents a hypothesis based on observational findings rather than experimental manipulation or causation studies. The preliminary anticoagulation data come from a small, uncontrolled report and do not establish efficacy or safety of 'triple therapy.' The findings cannot be generalized to all Long COVID patients, and microclots may be a consequence rather than a primary cause of disease. Long-term outcome data and controlled trials are needed before clinical recommendations can be made.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Kell, Douglas B, Laubscher, Gert Jacobus, & Pretorius, Etheresia (2022). A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications.. The Biochemical journal. https://doi.org/10.1042/BCJ20220016
BibTeX
@article{mecfsatlas-kell-2022-central-role,
author = {Kell, Douglas B and Laubscher, Gert Jacobus and Pretorius, Etheresia},
title = {A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications.},
journal = {The Biochemical journal},
year = {2022},
doi = {10.1042/BCJ20220016},
note = {PubMed: 35195253},
url = {https://www.mecfsatlas.com/evidence/kell-2022-central-role},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/kell-2022-central-role
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