a UK doctor Kell and a SA doctor Pretorius have been leading the charge on this work on microclots since around 2020
they have found them in people with CFS as well as long COVID and i would guess they also exist in most people with Chronic Lyme also
they found they are a mix of amyloid and fibrin and result from hypercoagulation and platelet hyperactivation.
( my bloodwork shows massive platelet activation on occasion)
its somewhat related to the work by Bruce Patterson on inflammation in the microvasculature - which he identified was driven by two specific mechanisms - including a kind of immortal specialised white blood cell that was triggering the inflammation - which was driving the symptoms
he showed dramatic improvements with a treatment designed to allow the die off of those rouge white cells and has government grants to set up testing and clinic to supply this treatment in several countries - USA, Europe and UK i think
of the patients that get tested he believes his test can differentiate something like 60% have long covid - 20% have CFS and another 20% have chronic lyme - all just reported to his clinic with suspected long covid / symptoms of ongoing fatigue
essentially he believes that these rogue white cells continue to carry the antigens from pathogens that triggered the condition - but because they have become long lasting - rather than dying off as they should - the symptoms also continue long term
the mechanism is general - pretty much any infection can trigger it - but i suspect tose that live in the blood or blood vessels wall and cause inflammation there are more likely to
some viruses ( covid does) - bart is an obvious one - lyme drills through the endothelial cells - so is another candidate - TBRF - brucellosis - Q-fever - rickettsia etc etc