Evidence map›Paper›PMID 41613157›Full record

ArticleFrontiers in human neuroscience2025

Autonomic small fiber involvement in painful long COVID: a histological and clinical study.

Pietro Falco, Eleonora Galosi, Daniel Litewczuk, Enrico Evangelisti, Giulia Di Stefano, Lars Arendt-Nielsen, Andrea Truini, Caterina Maria Leone

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In one paragraph

Article in Frontiers in human neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07682090 (RESET-FMS), which is not on this map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07682090 narecruitingnot on this mapstarted 2026, after this paper: background citation

RESET-FMS: A Randomized Sham-Controlled Trial of Transcutaneous Vagus Nerve Stimulation for Pain, Autonomic Dysfunction, and Fatigue in Patients With Fibromyalgia Syndrome

TypeinterventionalSponsorUniversity of Roma La SapienzaRan2026 to 2027Enrolled80ConditionsFibromyalgia SyndromeArmsTranscutaneous Vagus Nerve Stimulation, Sham Transcutaneous Vagus Nerve Stimulation
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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Pietro FalcoDepartment of Human Neuroscience, Sapienza University, Rome, Italy.
Eleonora GalosiDepartment of Human Neuroscience, Sapienza University, Rome, Italy.
Daniel LitewczukDepartment of Human Neuroscience, Sapienza University, Rome, Italy.
Enrico EvangelistiDepartment of Human Neuroscience, Sapienza University, Rome, Italy.
Giulia Di StefanoDepartment of Human Neuroscience, Sapienza University, Rome, Italy.
Lars Arendt-NielsenCentre for Neuroplasticity and Pain, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark.
Andrea TruiniDepartment of Human Neuroscience, Sapienza University, Rome, Italy.
Caterina Maria LeoneDepartment of Human Neuroscience, Sapienza University, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Despite growing recognition of painful long COVID syndrome as a chronic neurological condition marked by pain and autonomic symptoms, the precise contribution of autonomic small fiber involvement is still not well characterized and understood. In this retrospective study, we aimed to identify autonomic small fiber involvement in patients with painful long COVID syndrome by analyzing skin biopsy data. We used nerve fiber density in the piloerector muscles (PMNFD) and sweat glands (SGNFD) as the primary histological outcomes of autonomic innervation. Methods: We reviewed skin biopsy samples from 50 patients with painful long COVID syndrome and included 31 patients with available PMNFD and SGNFD data for analysis. PMNFD and SGNFD were compared with an age- and sex-matched healthy control group ( Results: Piloerector muscle nerve fiber density and SGNFD were significantly reduced in patients with long COVID compared with controls, both in the full sample ( Conclusion: These findings provide histological evidence that autonomic small fiber damage is a prominent and measurable feature of painful long COVID syndrome. Importantly, this pathology was also observed in patients with preserved IENFD, indicating that autonomic involvement may occur independently of somatic small fiber loss.

Indexed as

autonomic dysfunctionlong COVIDpainskin biopsysmall fiber neuropathy (SFN)

Identifiers

PMID41613157
PMCPMC12847426

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