Polli, Andrea, Godderis, Lode, Martens, Dries S et al. · BMC medicine · 2025 · DOI
This study followed 358 people who had COVID-19 to understand why some develop Long-COVID with symptoms like extreme fatigue, sleep problems, and post-exertional malaise (feeling much worse after activity). Researchers measured biological markers in blood and found that two factors—elevated troponin T (a heart protein) and shortened telomeres (the protective caps on DNA)—were most strongly linked to Long-COVID, particularly the fatigue cluster. The study shows that Long-COVID is not a single illness but has different symptom patterns, suggesting different underlying causes may be at play.
This study is important because it identifies potential biological mechanisms underlying Long-COVID and PEM, two conditions closely related to ME/CFS. By linking cardiac markers and cellular aging (telomere shortening) to persistent symptom clusters, it provides biological support for why some patients develop debilitating fatigue and post-exertional symptoms, potentially guiding future diagnostic and therapeutic approaches.
This study cannot prove that troponin T elevation or telomere shortening *cause* Long-COVID or PEM; they are merely associated markers. The predominantly hospitalized sample limits generalizability to mild Long-COVID cases, and the cross-sectional molecular measurements prevent determining whether these biological changes precede, accompany, or result from Long-COVID symptoms. Association does not establish causation or identify the underlying disease mechanisms.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Polli, Andrea, Godderis, Lode, Martens, Dries S, Patil, Madhura Shekhar, Hendrix, Jolien, Wyns, Arne, et al. (2025). Exploring DNA methylation, telomere length, mitochondrial DNA, and immune function in patients with Long-COVID.. BMC medicine. https://doi.org/10.1186/s12916-025-03881-x
BibTeX
@article{mecfsatlas-polli-2025-exploring-dna,
author = {Polli, Andrea and Godderis, Lode and Martens, Dries S and Patil, Madhura Shekhar and Hendrix, Jolien and Wyns, Arne and Van Campenhout, Jente and Richter, Emma and Fanning, Lara and Vandekerckhove, Olivia and Claeys, Eveline and Janssens, Wim and Lorent, Natalie},
title = {Exploring DNA methylation, telomere length, mitochondrial DNA, and immune function in patients with Long-COVID.},
journal = {BMC medicine},
year = {2025},
doi = {10.1186/s12916-025-03881-x},
note = {PubMed: 39901177},
url = {https://www.mecfsatlas.com/evidence/polli-2025-exploring-dna},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/polli-2025-exploring-dna
Contribute
Private, reviewed by a human. Not a public comment thread.