The event, now in its third year, also revealed updates about clinical trials and healthcare for the disease
Researchers, clinicians, and patient representatives met last week in Boston, Massachusetts, for the third Long COVID International Conference.
Formerly called the “Demystifying Long COVID International Conference,” the event crossed the Atlantic after 2023 and 2024 iterations in Spain. The hybrid event featured two full days of presentations, posters, and roundtable discussions on November 19 and 20. Biomarker and mechanism research was a key focus of the meeting, with two sessions full of study presentations and a panel discussion devoted to the topic.
The conference’s organizing and scientific committees were composed of leading researchers as well as a handful of patient advocates and patient researchers, who selected experts with research and clinical experience in Long COVID to present.
The meeting’s goal was “to really create a forum for people to share their science” entirely focused on Long COVID, said Igho Ofotokun, a member of the organizing committee and chair of the department of medicine at University Hospitals in Ohio, in an interview with The Sick Times. “I think the goal was accomplished.”
Along with biological research talks, the conference featured presentations from clinicians about their work caring for people with Long COVID. Gathering people with lived experience, clinicians “who are at the forefront of telling us what the condition looks like,” and scientists studying underlying biology all “in the same room” advances progress toward treatments, Ofotokun said.
The conference did not require preventative COVID-19 measures like masking during sessions, unlike other Long COVID events such as this year’s Keystone Symposia meeting. But it did make the event accessible to people with Long COVID with a discounted virtual rate of $20, compared to the conference’s standard virtual fee of $595 to $845.
The Sick Times attended the conference virtually. As it was a closed science meeting, we couldn’t report on all of the talks, but we reached out to some scientists and clinicians for permission to share summaries of their presentations. Here are some of our key takeaways.
Studying Long COVID’s underlying biology
Lenny Coppens, a PhD student at the University of Antwerp, shared research on identifying SARS-CoV-2 spike protein in the blood, using samples from the European Union’s ORCHESTRA project. He found that a compound called dithiothreitol (DTT), often used in preparing samples for genetic testing, may degrade the spike protein and interfere with results. In addition, when Coppens and his colleagues compared blood samples between people who had Long COVID and those without long-term symptoms after COVID-19, they did not find meaningful differences in spike protein levels. Coppens’ work, also shared last month as a preprint, adds to past research showing that identifying viral persistence is often more complicated than it seems.
Rebeca Santano and Gemma Moncunill from the Barcelona Institute for Global Health (ISGlobal) shared findings from their team’s investigations into immune system dysfunction in Long COVID, in two separate talks. People with Long COVID consistently had lower antibody levels than those who appeared to have recovered from COVID-19, Santano explained, and antibody levels tended to decrease after a new infection more quickly in those with Long COVID than in the control group. Moncunill’s talk focused on T cells, describing evidence that different types of T cells are not serving their correct functions in the immune system of people with Long COVID. T cells could be a target for treatment, she said.
Andrew Grimson from Cornell University also focused on T cells during his talk, drawing connections between immune system dysfunction in Long COVID and myalgic encephalomyelitis (ME). Grimson works with Maureen Hanson at Cornell’s multidisciplinary ME research center. His lab has identified specific issues with a type of T cell called CD8+ T cells, which have been studied in Long COVID as well as cancer. “If there’s an infection or cancer that the immune system can’t clear,” CD8+ T cells enter an exhausted state where they “give up the fight,” he said, explaining that these cells may be a marker of chronic viral infection in ME.
“If there’s an infection or cancer that the immune system can’t clear,” CD8+ T cells enter an exhausted state where they “give up the fight.”
Andrew Grimson, Cornell University
Hanna Ollila from the University of Helsinki discussed potential genetic risk factors for Long COVID and related diseases. She shared findings from the Long COVID Host Genetics Initiative, which published a major paper this spring that found a possible genetic signal for Long COVID across groups of people in 16 different countries and offered insight into the disease’s underlying biological mechanisms. Ollila and her colleagues are also collaborating with a group studying genetic factors in fibromyalgia and with the DecodeME project.
Lindsay McAlpine from Yale University gave a presentation on brain imaging of people with Long COVID. Using magnetic resonance imaging (MRI), her team compared 32 people with Long COVID who had cognitive dysfunction to 22 “recovered” controls. They did not find significant differences in blood flow to the brain between the groups, but did find reduced gray matter in people with Long COVID, specifically in areas critical for language, memory, and sensory processing.
Johan van Weyenbergh from the Rega Institute for Medical Research shared updates to his work on a potential Long COVID biomarker, expanding from a 2024 paper in The Lancet: Microbe that looked at the blood of people with Long COVID and found persistent SARS-C0V-2 RNA. His latest study, which is not yet published, found that main protease (Mpro), an enzyme found in SARS-C0V-2 that is the target of the antiviral drug Paxlovid, was elevated in some people with Long COVID who struggled with exercise and were positive for spike protein. “We do believe this might be a biomarker for patient-reported fitness,” he said.
Van Weyenberg has further tested this potential biomarker by collaborating with Karolinska Institute researchers on their Paxlovid clinical trial, he said. Those researchers are working on a paper with their results.
Innovations in clinical care
Alba Azola kicked off a series of talks about clinical care for Long COVID by describing how she approaches caring for patients at Johns Hopkins University’s Long COVID and ME clinic. The clinic includes internists as well as referral options for specialists familiar with Long COVID, psychology and psychiatric care, and physical and occupational therapy, she said. Azola and her colleagues screen their patients for other chronic diseases that frequently occur alongside Long COVID, including ME, dysautonomia, mast cell activation syndrome, hypermobility, craniocervical instability, and vascular compression syndromes.
People with Long COVID and related diseases “require a lot more time” than insurance plans typically cover, Azola said, noting the limitations in areas like prescribing medications off-label. She also highlighted that people with these diseases should try to avoid new infections.
Melvin Lafeber, an internal medicine doctor from the Netherlands, described the country’s “Post-COVID” Academic Centers of Expertise. These Long COVID centers opened last year with funding from the Dutch government, and offer a standardized treatment protocol that includes education about pacing and energy management as well as off-label medications such as low-dose naltrexone, ivabradine, and nicotine patches. As of September 2025, the centers have seen about 500 patients but their waiting list has over 15,000 people, Lafeber said.
Jacqueline Becker, a neuropsychologist at Mount Sinai, shared an update on one of the New York City health system’s Long COVID clinics, which focuses on underserved communities and improving primary care providers’ knowledge of Long COVID in Harlem and the South Bronx. This clinic opened about two years ago with funding from the Agency for Healthcare Research and Quality (AHRQ), and has since seen about 400 patients. Becker and her colleagues also train clinicians and medical students at Mount Sinai in infection-associated chronic conditions, which she noted is key to expanding this high-demand field.
While there have been some questions about AHRQ’s Long COVID funding, Becker confirmed in an email to The Sick Times that Mount Sinai’s grant is “in good standing and set to expire in 2028.”
Emma Tippett presented twice at the conference about her work at Clinic Nineteen, an all-virtual clinic in Australia. The clinic has served about 1,300 Australians with Long COVID, including children. One of their core principles is that “Long COVID is a biomedical disease,” and so they focus on offering medications, Tippett said, adding that they don’t recommend cognitive behavioral therapy (CBT) or graded exercise therapy (GET). (In an email toThe Sick Times, Tippett noted that the clinic can see only patients based in Australia.)
Her second talk described Clinic Nineteen’s experience prescribing low-dose naltrexone (LDN), which is the clinic’s most common treatment. LDN is “not a silver bullet” but helps reduce symptoms for many people, Tippett said; for her patients, it often helps them do a bit more activity each day while still carefully pacing.
One of [Clinic Nineteen’s] core principles is that “Long COVID is a biomedical disease,” and so they focus on offering medications, Tippett said, adding that they don’t recommend cognitive behavioral therapy (CBT) or graded exercise therapy (GET).
Updates on clinical trials
Edmarie Guzmán-Vélez from Rutgers University shared results from a trial of the supplement nicotinamide riboside (NR), also recently published in a paper in The Lancet eClincial Medicine. The small trial included 58 participants, all of whom were able to try the supplement, as the study used a crossover design. Overall, the study didn’t find a significant difference in changes to cognitive symptoms between the treatment and placebo groups, but the supplement did lead to improved levels of the enzyme that NR targets. Guzmán-Vélez and her colleagues are analyzing the data further to better understand which participants saw the most benefit, she said.
The University of California, San Francisco’s Long-term Impact of Infection with Novel Coronavirus (LIINC) program was well represented at the conference, in talks and the panel discussion about biomarkers. One of those talks, by pharmacology researcher Amelia Deitchman, previewed analysis from the group’s outSMART-LC clinical trial of the monoclonal antibody AER002. In an email to The Sick Times, lead investigator Michael Peluso said that a preprint with detailed results from that trial will likely be available next month.
The conference also featured updates on RECOVER-VITAL, a National Institutes of Health-funded trial testing Paxlovid to treat potential viral persistence, as well as STIMULATE-ICP, a large trial in the U.K. comparing an “integrated care pathway” to more standard Long COVID care. The results from those trials are not yet public, but we plan on covering these in our research updates and in other coverage as soon as they are available.
Betsy Ladyzhets and Miles Griffis virtually attended the conference and contributed reporting and writing to this story.
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