• CLINICAL REFERENCE – UPDATED 2026

Long COVID,

understood.

A plain-language reference on post-viral illness, spike protein persistence, and the recovery science behind the Terrain Protocol. Every claim is cited.

01 – Overview

02 – Scale

03 – Spike protein 101

04 – Persistence

05 – Symptom map

06 – Neurocognitive

07 – Vascular & immune

08 – Recovery science

09 – Botanicals & polyphenols

10 – Publications

11 – FAQ

CITATION POLICY

Every section cites primary peer-reviewed literature. Where evidence is preliminary, we say so. No claim is made beyond what the data support.

01 – OVERVIEW

What Long COVID actually is.

Long COVID — formally Post-Acute Sequelae of SARS-CoV-2 (PASC) — is a chronic, multi-system condition that persists beyond the acute infection. It is not one disease. It is a pattern: a viral insult that fails to fully resolve, leaving a cascade of immune, vascular, and neurological dysfunction.

The defining feature is persistence — of symptoms, of inflammation, and increasingly of evidence that components of the virus itself remain in the body long after recovery.

“You don’t look sick” is the most common phrase Long COVID patients hear.

02 – SCALE

You are not alone - by the numbers.

400M+

estimated to have experienced Long COVID worldwide

Al-Aly et al., Nat Med 2024

6.9%

of U.S. adults report a history of Long GOVID

CDC Household Pulse, 2024

200+

symptons documented across ≥10 organ systems

Davis et al., EClinicalMedicine 2021

15 mo+

spike protein detected in monocytes post-infection

Patterson et al., Front Immunol 2022

03 – SPIKE PROTEIN 101

The spike protein - what it is, why it matters.

The spike (S) protein is the molecular key SARS-CoV-2 uses to enter human cells, binding the ACE2 receptor found across the vascular endothelium, heart, gut, kidneys and brain. It is not merely a structural component — it is itself biologically active.

In isolation, spike has been shown to induce endothelial dysfunction, mitochondrial injury, and inflammatory signaling — independent of viral replication. This is why its persistence matters far beyond the acute infection.

REFERENCES

↳Lei et al., Circulation Research 2021 — spike-induced endothelial damage

↳Suzuki et al., Vascular Pharmacology 2021 — ACE2 + MEK/ERK inflammation

04 – PERSISTENCE

Spike doesn't always leave.

Across at least four independent research groups, spike protein has been detected in patients months — and in some cases over a year — after the original infection. The implication: the immune system is not just remembering the virus; in some people, it is still responding to it.

Fibrinaloid microclots have been observed in Long COVID circulation, partially resistant to normal fibrinolysis. Pretorius et al., 2022.

EVIDENCE

Patterson, 2022

SARS-CoV-2 S1 detected in non-classical monocytes up to 15 months post-infection in PASC patients.

EVIDENCE

Swank, 2023

Ultrasensitive Simoa assay detected circulating spike antigen in 60%+ of long-haulers tested.

EVIDENCE

Brogna, 2023

Spike protein detected in plasma of vaccinated individuals up to six months post-vaccination.

EVIDENCE

Pretorius, 2023

Microclots resistant to standard fibrinolysis correlate with Long COVID symptom severity.

Mechanism: persistent spike → endothelial inflammation → microvascular dysfunction → multi-organ symptom expression.

05 – THE SYMPTOM MAP

One condition, ten systems.

Because ACE2 is expressed throughout the body, spike-driven dysfunction is rarely confined to one organ. This is why two Long COVID patients can look entirely different.

SYSTEM

Neurological

Brain fog
Headache
Dizziness
Sensory changes
Sleep disruption

SYSTEM

Cardiovascular

Palpitations
POTS
Orthostatic intolerance
Chest pain
Microclots

SYSTEM

Respiratory

Air hunger
Cough
Reduced exercise tolerance
Shortness of breath

SYSTEM

Immune

New allergies
MCAS-like reactions
Autoimmune flares
Reactivated EBV/HSV

SYSTEM

GI & metabolic

Bloating
Food intolerances
Blood sugar shifts
Microbiome disruption

SYSTEM

Energy & musculoskeletal

Fatigue
Post-exertional malaise
Myalgia
Joint pain

05 – THE SYMPTOM MAP

One condition, ten systems.

Because ACE2 is expressed throughout the body, spike-driven dysfunction is rarely confined to one organ. This is why two Long COVID patients can look entirely different.

01 · A QUIET SELF-CHECK

How many of these sound like your year?

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DR. SHERRI TENPENNY

Doctor, Speaker, Educator, Consultant

DR. SHERRI TENPENNY

Doctor, Speaker, Educator, Consultant

Long COVID,

understood.

A plain-language reference on post-viral illness, spike protein persistence, and the recovery science behind the Terrain Protocol. Every claim is cited.

CONTENTS

What Long COVID actually is.

The defining feature is persistence — of symptoms, of inflammation, and increasingly of evidence that components of the virus itself remain in the body long after recovery.

You are not alone - by the numbers.

400M+

estimated to have experienced Long COVID worldwide

6.9%

of U.S. adults report a history of Long GOVID

200+

symptons documented across ≥10 organ systems

15 mo+

spike protein detected in monocytes post-infection

The spike protein - what it is, why it matters.

The spike (S) protein is the molecular key SARS-CoV-2 uses to enter human cells, binding the ACE2 receptor found across the vascular endothelium, heart, gut, kidneys and brain. It is not merely a structural component — it is itself biologically active.

In isolation, spike has been shown to induce endothelial dysfunction, mitochondrial injury, and inflammatory signaling — independent of viral replication. This is why its persistence matters far beyond the acute infection.

Spike doesn't always leave.

Across at least four independent research groups, spike protein has been detected in patients months — and in some cases over a year — after the original infection. The implication: the immune system is not just remembering the virus; in some people, it is still responding to it.

Patterson, 2022

Swank, 2023

Brogna, 2023

Pretorius, 2023

One condition, ten systems.

Because ACE2 is expressed throughout the body, spike-driven dysfunction is rarely confined to one organ. This is why two Long COVID patients can look entirely different.

Neurological

Cardiovascular

Respiratory

Immune

GI & metabolic

Energy & musculoskeletal

One condition, ten systems.

Because ACE2 is expressed throughout the body, spike-driven dysfunction is rarely confined to one organ. This is why two Long COVID patients can look entirely different.

01 · A QUIET SELF-CHECK

How many of these sound like your year?

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