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Disrupted cortisol patterns help explain many of the symptoms long COVID patients consistently report, including: Fatigue Sleep dysfunction Inflammatory amplification Poor stress resilience Gut Microbiome Disruption COVID-19 causes significant gut microbiome disruption during acute infection, and research shows this disruption can persist for months in long COVID patients

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Simultaneously, Akt activation suppresses the ubiquitin proteasome system through inhibition of FoxO-mediated transcription of E3 ubiquitin ligases (MAFbx/Atrogin-1, MuRF1), which are responsible for protein degradation