Summary
| Direction in Long COVID | ↑ Elevated — higher than in the comparison group |
|---|---|
| Category | Inflammatory |
| Also described as | Pro-inflammatory cytokine |
| Compared against | HC, R (healthy controls, recovered individuals without persistent symptoms) |
| Associated symptoms | Fatigue, myalgia |
| Test type | Blood test (serum / plasma / whole blood) |
| LOINC code | 3074-8 |
| Source | Lai et al. 2023; Saito et al. 2024 — doi:10.3389/fimmu.2024.1341843 |
| Condition atlas | Long COVID Biomarker Atlas |
Other conditions where Tumor Necrosis Factor-α (TNF-α) is reported
- Tumor Necrosis Factor-α (TNF-α) in Gulf War Illness — ↑ elevated vs HGV
- Tumor Necrosis Factor-α (TNF-α) in ME/CFS — ↕ inconsistent vs HC
See the cross-condition hub: Tumor Necrosis Factor-α (TNF-α) across conditions.
Trials, interventions and tests
In clinical-trial registrations this marker maps to the outcome term Tumor Necrosis Factor-alpha (TNF-α) (10 registered trials use a matching outcome measure).
Clinical trials using Tumor Necrosis Factor-α (TNF-α) as an outcome
- NCT07278206: Brain Stimulation in Long COVID (Recruiting)
Outcome measure: Tumor Necrosis Factor-alpha (TNF-α) - NCT07285707: Acupuncture and Chinese Herbal Medicine for Long COVID (Recruiting)
Outcome measure: Change in Laboratory Biomarkers - Tumor necrosis factor-alpha - NCT06073002: Effects of a Home-Based Exercise Intervention in Subjects with Long COVID (Active Not Recruiting)
Outcome measure: Change of tumor necrosis factor alpha (TNF-α measured in pg/ml) - NCT05848518: Exercise for Health in Patients With Post-acute Sequelae of COVID-19 (Completed)
Outcome measure: Concentration of biomarkers of inflammation: Tumor necrosis factor - NCT05204511: Exercise and Post-COVID/ Long-COVID: Effects of Different Training Modalities on Various Parameters in People Affected by the Sequelae of COVID-19 (Completed)
Outcome measure: Change of tumor necrosis factor alpha (TNF-α measured in pg/ml) - NCT06064838: Effects of Cacao Flavonoids in Long COVID-19 Patients (FLALOC) (Completed)
Outcome measure: TNF-alpha - NCT06042777: Non-pharmacological and TCM-based Treatment for Long COVID Symptoms (Unknown)
Outcome measure: Neurobiological outcomes - NCT06211062: The Use of Directed Probiotics in ME/CFS: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Recruiting)
Outcome measure: The pro-inflammatory cytokines level e.g. IL-1, IL-6, and TNF-α
2 more trials reference this marker.
Interventions studied alongside this marker
Hypothesis-generating links from trial outcome usage and literature co-occurrence. Not treatment recommendations.
- Exercise therapy — 2 trials, 6 PubMed co-citations
e.g. Concurrent improvement of cardiorespiratory fitness and modulation of inflammatory markers via 12-week… - Repetitive Transcranial Magnetic Stimulation — 1 trial, 6 PubMed co-citations
e.g. Chronic Pain and Major Depression: Shared Psychological and Neurobiological Mechanism. - Acupuncture — 1 trial, 6 PubMed co-citations
e.g. Clinical investigation of plasma HIF-1α and inflammatory biomarkers in dogs with thoracolumbar… - Endurance Training — 1 trial, 6 PubMed co-citations
e.g. Endurance training increases tmTNF-α and IL-6 levels in several vital organs in rats: relationship with… - Concurrent Training — 1 trial, 6 PubMed co-citations
e.g. Synergistic Effects of Microencapsulated Polyphenols and Concurrent Training on Metabolic Health and Fitness… - Coenzyme Q10 — 1 trial, 6 PubMed co-citations
e.g. Effects of Coenzyme Q10 on Lipid, Glycemic, and Inflammatory Markers in Metabolic Disorders: A Systematic…
Commercial test availability
Tumor Necrosis Factor-α (TNF-α) — commercial laboratory test. Often send-out; availability varies by region.
Links are for reference only; availability, specimen requirements and coverage vary by location.
Related Inflammatory markers in Long COVID
- Interleukin-6 (IL-6) ↑
- Interleukin-1α (IL-1α) ↑
- C-Reactive Protein (CRP) ↑
- Soluble CD14 (sCD14) ↑
- Flt-1 / sVEGFR-1 ↑
- CCL4 (MIP-1β) ↑
- Cystatin D (CST5) ↑
- Pro-inflammatory cytokines (composite) ↓
Full list: Long COVID Biomarker Atlas.
Frequently asked questions
Is Tumor Necrosis Factor-α (TNF-α) high or low in Long COVID?
Elevated. Studies summarised in the OSMF atlas report higher Tumor Necrosis Factor-α (TNF-α) in Long COVID than in healthy controls, recovered individuals without persistent symptoms. Source: Lai et al. 2023; Saito et al. 2024.
What symptoms is Tumor Necrosis Factor-α (TNF-α) associated with in Long COVID?
The cited literature associates this marker with Fatigue, myalgia. These are population-level associations and do not mean the marker causes the symptoms.
Which test measures Tumor Necrosis Factor-α (TNF-α)?
It is measured as a blood test (serum / plasma / whole blood). The standard laboratory code is LOINC 3074-8. Commercial laboratories such as Quest Diagnostics, LabCorp list an orderable assay.
Is one abnormal Tumor Necrosis Factor-α (TNF-α) result diagnostic of Long COVID?
No. No single biomarker is diagnostic of Long COVID. Tumor Necrosis Factor-α (TNF-α) findings come from group comparisons, overlap considerably between patients and controls, and vary with study design, timing and comparison group. A result should be interpreted by a clinician alongside symptoms, history and other tests.
Is Tumor Necrosis Factor-α (TNF-α) specific to Long COVID?
No. The same marker is also reported in Gulf War Illness, ME/CFS in this atlas, so it reflects shared biology (for example inflammation or vascular stress) rather than a condition-specific signature.
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Last reviewed: 2026-06-29 · Page generated from long-covid.json · Browse: Long COVID atlas · Biomarker Index · All marker pages
Disclaimer: This page is an educational synthesis of published, peer-reviewed research and is not medical advice. Biomarker findings vary across studies with case definitions, comparison groups, timing and assay methods. Direction of change reflects the predominant finding in the cited source and does not establish a diagnostic threshold. Discuss any test result with a qualified clinician.