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. 2023 Jul 4;28(12):4968–4976. doi: 10.1038/s41380-023-02161-5

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 3 — Patients with long COVID have persistent dysbiosis of the gut microbiome, resulting in a number of persistent GI symptoms, as well as neurological and psychiatric symptoms through the gut–brain axis. A plant-based diet, probiotics and prebiotics, and microbiome-derived metabolites [e.g., short-chain fatty acids (SCFAs: butyrate)] may have prophylactic or therapeutic potential for patients with long COVID. Given the role of the gut–microbiota–brain axis in neuroinflammation, fecal microbiota transplantation (FMT) from healthy controls may be a potential therapeutic tool for patients with long COVID. In addition, given the crucial role of the vagus nerve in the gut–brain axis, vagus nerve stimulation (VNS) could improve a number of neurological and psychiatric symptoms in patients with long COVID. This is a slight modification of a previously published figure [94]. Part of the figure was designed using resources from Biorender.com.