Long COVID Research Project

A personal research and treatment-planning knowledge base for long COVID (Post-Acute Sequelae of SARS-CoV-2 / PASC), built from 2025–2026 clinical literature, RCT results, and specialist protocols.

A structured, source-linked synthesis of the current state of long COVID science — organized around:

1. A unified root-cause model (the "Damaged Triad" hypothesis: gut, endothelium, vagus nerve as a self-reinforcing loop)
2. Treatment options by evidence tier (RCTs, case series, experimental)
3. Practical protocols for specific drugs (e.g., bupropion) and lifestyle interventions
4. Curated primary sources organized by topic

Built collaboratively with Claude (Anthropic) using research and reasoning across the 2025–2026 literature.

• ❌ Medical advice
• ❌ A substitute for a physician
• ❌ A peer-reviewed publication
• ❌ Guaranteed accurate — this is a working understanding subject to update as new evidence emerges

All content is for educational/personal-planning purposes only. Consult a qualified physician before making any medical decisions.

long_covid/
├── README.md                  ← You are here
├── CLAUDE.md                  ← Instructions for AI collaboration
├── LICENSE                    ← MIT
├── .gitignore                 ← Personal notes excluded by default
├── docs/                      ← Public research content
│   ├── 01-triad-model.md      ← Root-cause hypothesis (hardware layer)
│   ├── 02-treatments.md       ← Treatment evidence tiers
│   ├── 03-bupropion-guide.md  ← Bupropion practical guide
│   ├── 04-unified-model.md    ← The Stuck Sickness Program (full unified RCA)
│   ├── 05-mast-cell-gut-protocol.md ← Food-reactive / mast-cell phenotype: anatomy, drugs (India), tests
│   └── sources.md             ← Curated references
└── personal/                  ← Personal application (gitignored)
    ├── README.md              ← Personal entry point
    ├── profile.md             ← Personal symptom profile
    └── action-plan.md         ← Personal 90-day plan

New readers should go:

1. docs/04-unified-model.md — The full unified RCA (start here)
2. docs/01-triad-model.md — The hardware layer (which tissues and why)
3. docs/02-treatments.md — What actually works and doesn't
4. docs/03-bupropion-guide.md — Deep-dive on one high-relevance drug
5. docs/05-mast-cell-gut-protocol.md — The gut mast-cell / vagal-afferent phenotype and its protocol
6. docs/sources.md — Primary literature

Long COVID is a self-sustaining inflammatory loop between the gut epithelium, vascular endothelium, and vagus nerve — three ACE2-receptor-rich tissues SARS-CoV-2 preferentially damages. Once damaged, each leg feeds injury to the other two, forming a positive-feedback cycle that continues long after the acute virus is cleared. Every observed long COVID phenomenon — microclots, neuroinflammation, mitochondrial dysfunction, serotonin depletion, dopamine loss, HPA flattening, POTS, autoantibodies, EBV reactivation, PEM — is downstream of this loop. Full recovery requires breaking the loop at multiple points simultaneously, which explains why single-drug trials keep failing while multi-modal protocols at LC clinics succeed.

See docs/01-triad-model.md for the full model, mapped observations, and mechanistic evidence.

This is a personal research project. If you're another long COVID researcher, patient, or clinician who wants to suggest additions/corrections:

• Open an issue with the specific citation
• Reference primary literature (RCTs, meta-analyses, mechanism papers) rather than blog posts where possible
• Flag anything that turned out to be wrong so I can update

MIT — free to use, modify, redistribute with attribution. See LICENSE.

• NIH RECOVER Initiative for the trial infrastructure
• Patient-Led Research Collaborative for pushing the field forward
• Berlin Cures, Yale (Arnsten group), Pretorius group, RTHM clinic for mechanism + treatment research
• Anthropic / Claude for research assistance in compiling this synthesis

This is a living document. Last updated: 2026-08-18.