Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics

Post-COVID-19 Condition (PCC), impacting 30–90% of survivors, is characterized by persistent fatigue and metabolic dysfunction, often linked to underlying mitochondrial impairment. This review examines current evidence on mitochondrial-targeted nutrition therapies, with a focus on magnetic resonance...

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Main Authors: Li-zhen Chen, Qi Cai, Peng-fei Zheng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1597370/full
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author Li-zhen Chen
Li-zhen Chen
Qi Cai
Peng-fei Zheng
author_facet Li-zhen Chen
Li-zhen Chen
Qi Cai
Peng-fei Zheng
author_sort Li-zhen Chen
collection DOAJ
description Post-COVID-19 Condition (PCC), impacting 30–90% of survivors, is characterized by persistent fatigue and metabolic dysfunction, often linked to underlying mitochondrial impairment. This review examines current evidence on mitochondrial-targeted nutrition therapies, with a focus on magnetic resonance spectroscopy (MRS) as a tool for assessing metabolic recovery. Key findings highlight reduced adenosine triphosphate (ATP) production, heightened oxidative stress, and disrupted mitochondrial biogenesis- metabolic abnormalities that closely mirror those seen in chronic fatigue syndromes. While mitochondrial dysfunction is recognized as central, debate continues on whether systemic inflammation or direct viral damage primarily drives these abnormalities. Current evidence supports nutrients, such as, CoQ10, NAC, and creatine for restoring energy metabolism and reducing oxidative stress. MRS biomarkers (τPCr, Qmax), offer valuable tools for monitoring personalized intervention. However, several limitations persist, including variability in nutritional protocols, inconsistencies in MRS methodologies, and limited consideration of microbiome-psychosocial interactions. Most clinical trials focus on short-term outcomes, lacking data on long-term efficacy or stratification based on mitochondrial dysfunction severity. Future research priorities include multi-omics investigations into mitochondrial-epigenetic interactions, the development of targeted antioxidants, and exploration of engineered microbial metabolites. Standardizing MRS protocols, validating composite endpoints, and optimizing nutrient delivery systems require interdisciplinary collaboration. This review advocates for a precision medicine approach, combining MRS-based metabolic profiling with personalized nutritional strategies, to address the multifactorial nature of PCC and advance clinical translation.
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spelling doaj-art-5e3db894467f4e4aaffc2ec079eff5fd2025-08-20T02:25:47ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.15973701597370Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeuticsLi-zhen Chen0Li-zhen Chen1Qi Cai2Peng-fei Zheng3Department of Pharmacy, The First Hospital of Putian City, Putian, Fujian, ChinaCollege of Environmental and Biological Engineering, Putian University, Putian, Fujian, ChinaSchool of Medicine, Nankai University, Tianjin, ChinaSchool of Computer Science and Technology, University of Science and Technology of China, Hefei, Anhui, ChinaPost-COVID-19 Condition (PCC), impacting 30–90% of survivors, is characterized by persistent fatigue and metabolic dysfunction, often linked to underlying mitochondrial impairment. This review examines current evidence on mitochondrial-targeted nutrition therapies, with a focus on magnetic resonance spectroscopy (MRS) as a tool for assessing metabolic recovery. Key findings highlight reduced adenosine triphosphate (ATP) production, heightened oxidative stress, and disrupted mitochondrial biogenesis- metabolic abnormalities that closely mirror those seen in chronic fatigue syndromes. While mitochondrial dysfunction is recognized as central, debate continues on whether systemic inflammation or direct viral damage primarily drives these abnormalities. Current evidence supports nutrients, such as, CoQ10, NAC, and creatine for restoring energy metabolism and reducing oxidative stress. MRS biomarkers (τPCr, Qmax), offer valuable tools for monitoring personalized intervention. However, several limitations persist, including variability in nutritional protocols, inconsistencies in MRS methodologies, and limited consideration of microbiome-psychosocial interactions. Most clinical trials focus on short-term outcomes, lacking data on long-term efficacy or stratification based on mitochondrial dysfunction severity. Future research priorities include multi-omics investigations into mitochondrial-epigenetic interactions, the development of targeted antioxidants, and exploration of engineered microbial metabolites. Standardizing MRS protocols, validating composite endpoints, and optimizing nutrient delivery systems require interdisciplinary collaboration. This review advocates for a precision medicine approach, combining MRS-based metabolic profiling with personalized nutritional strategies, to address the multifactorial nature of PCC and advance clinical translation.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1597370/fullpost-COVID-19 conditionmitochondrial dysfunctionnutritionmagnetic resonance spectroscopyprecision medicine
spellingShingle Li-zhen Chen
Li-zhen Chen
Qi Cai
Peng-fei Zheng
Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics
Frontiers in Immunology
post-COVID-19 condition
mitochondrial dysfunction
nutrition
magnetic resonance spectroscopy
precision medicine
title Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics
title_full Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics
title_fullStr Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics
title_full_unstemmed Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics
title_short Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics
title_sort mitochondrial metabolic rescue in post covid 19 syndrome mr spectroscopy insights and precision nutritional therapeutics
topic post-COVID-19 condition
mitochondrial dysfunction
nutrition
magnetic resonance spectroscopy
precision medicine
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1597370/full
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