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The other outcome from the audit was that patients were under investigated and the aetiology of the B12 deficiency was not fully ascertained

Research from a 2023 article found significant mitochondrial structural and functional abnormalities in the muscle cells of long COVID patients, including: Disrupted cristae (mitochondrial) architecture Impaired electron transport chain function Reduced ATP production capacity These findings mirror what we see in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a condition that shares significant overlap with long COVID and is now thought to involve similar mitochondrial pathology

Boyden, T

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These effects can lead to: Reduced dietary intake of B12-rich foods (meat, fish, dairy, eggs) Altered eating patterns with potential nutritional inadequacy Reduced nutritional intake if gastrointestinal symptoms are severe or prolonged Vitamin B12 deficiency can manifest with significant clinical consequences, including macrocytic anaemia, peripheral neuropathy, cognitive impairment, fatigue, and mood disturbances

A large population of GFP ve and FSP1 +ve allogenic fibroblasts were also observed (Fig