Rohrhofer, Johanna, Wolflehner, Viktoria, Schweighardt, Johannes et al. · Allergy · 2025 · DOI
This study looked at whether problems with the digestive system might help explain why some people develop long-lasting fatigue and other symptoms after COVID-19 (post-COVID syndrome). The researchers found that people with post-COVID fatigue had signs of gut inflammation and a leaky intestinal barrier, along with changes in immune markers in their blood. This suggests that COVID-19 may damage the gut in ways that contribute to long-term fatigue and post-exertional malaise.
ME/CFS and post-COVID syndrome share overlapping symptoms including fatigue, post-exertional malaise, and autonomic dysfunction. Understanding that gut barrier integrity and immune activation may drive these symptoms opens new diagnostic and therapeutic avenues. This work may help identify which patients are at risk and suggest targets for preventing or treating post-viral fatigue syndromes.
This study demonstrates association between GI barrier dysfunction and post-COVID fatigue but does not prove causation—the gut disruption could be a consequence rather than a cause of fatigue. The observational design cannot establish whether specific interventions targeting gut integrity would prevent or reverse post-COVID syndrome. Results are specific to post-COVID populations and may not generalize to ME/CFS of non-viral origin.
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
Rohrhofer, Johanna, Wolflehner, Viktoria, Schweighardt, Johannes, Koidl, Larissa, Stingl, Michael, Zehetmayer, Sonja, et al. (2025). Gastrointestinal Barrier Disruption in Post-COVID Syndrome Fatigue Patients.. Allergy. https://doi.org/10.1111/all.16593
BibTeX
@article{mecfsatlas-rohrhofer-2025-gastrointestinal-barrier,
author = {Rohrhofer, Johanna and Wolflehner, Viktoria and Schweighardt, Johannes and Koidl, Larissa and Stingl, Michael and Zehetmayer, Sonja and Séneca, Joana and Pjevac, Petra and Untersmayr, Eva},
title = {Gastrointestinal Barrier Disruption in Post-COVID Syndrome Fatigue Patients.},
journal = {Allergy},
year = {2025},
doi = {10.1111/all.16593},
note = {PubMed: 40372110},
url = {https://www.mecfsatlas.com/evidence/rohrhofer-2025-gastrointestinal-barrier},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/rohrhofer-2025-gastrointestinal-barrier
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