Increase in gut permeability and oxidized ldl is associated with post-acute sequelae of SARS-CoV-2.

Background: Post-acute sequelae of SARS-CoV-2 (PASC) is marked by persistent or newly developing symptoms beyond 4 weeks of infection. Investigating gut integrity, oxidized lipids and inflammatory markers is important for understanding PASC pathogenesis. Methods: A cross-sectional study including COVID+ with PASC, COVID+ without PASC, and COVID-negative (COVID-) participants. We measured plasma markers by enzyme-linked immunosorbent assay to assess intestinal permeability (ZONULIN), microbial translocation (lipopolysaccharide-binding protein or LBP), systemic inflammation (high-sensitivity C-reactive protein or hs-CRP), and oxidized low-density lipoprotein (Ox-LDL). Results: 415 participants were enrolled in this study; 37.83% (n=157) had prior COVID diagnosis and among COVID+, 54% (n=85) had PASC. The median zonulin among COVID- was 3.37 (IQR: 2.13, 4.91) mg/mL, 3.43 (IQR: 1.65, 5.25) mg/mL among COVID+ no PASC, and highest [4.76 (IQR: 3.2, 7.35) mg/mL] among COVID+ PASC+ (p<.0001). The median ox-LDL among COVID- was 47.02 (IQR: 35.52, 62.77) U/L, 57.24 (IQR: 40.7, 75.37) U/L among COVID+ No PASC, and the highest [76.75 (IQR: 59.95, 103.28) U/L] among COVID+ PASC+ (p<.0001). COVID+ PASC+ was positively associated with zonulin (p=0.0002) and ox-LDL (p<.0001), and COVID- was negatively associated with ox-LDL (p=0.01), compared to COVID+ No PASC. Every unit increase in zonulin was associated with 44% higher predicted odds of having PASC [aOR: 1.44 (95%CI: 1.1, 1.9)] and every one-unit increase in ox-LDL was associated with more than four-fold increased odds of having PASC [aOR: 2.44 (95%CI: 1.67, 3.55)]. Conclusions: PASC is associated with increased gut permeability and oxidized lipids. Further studies are needed to clarify whether these relationships are causal which could lead to targeted therapeutics.

The Protective Effect of Coronavirus Disease 2019 (COVID-19) Vaccination on Postacute Sequelae of COVID-19: A Multicenter Study From a Large National Health Research Network.

Background: Coronavirus disease 2019 (COVID-19) vaccines have been proven to decrease the severity of acute-phase infection; however, little is known about their effect on postacute sequelae of COVID-19 (PASC). Methods: Patients with confirmed COVID-19 diagnosis and minimum age of 18 years with 3-month follow-up postdiagnosis between 21 September 2020 and 14 December 2021 were identified from the TriNetX Research Network platform. The primary outcomes consisted of new-onset or persistent symptoms, new-onset diagnoses, and death and were compared between vaccine and no-vaccine groups. Results: At baseline, 1 578 719 patients with confirmed COVID-19 were identified and 1.6% (n = 25 225) completed vaccination. After matching, there were no differences (P > .05) in demographics or preexisting comorbidities. At 28 days following COVID-19 diagnosis, the incidence of hypertension was 13.52 per 1000, diabetes was 5.98 per 1000, thyroid disease was 3.80 per 1000, heart disease was 15.41 per 1000, and mental disorders was 14.77 per 1000 in the vaccine cohort. At 90 days following COVID-19 diagnosis, the relative risk of hypertension was 0.33 (95% confidence interval [CI], .26-.42), diabetes was 0.28 (95% CI, .20-.38), heart disease was 0.35 (95% CI, .29-.44), and death was 0.21 (95% CI, .16-.27). Differences in both 28- and 90-day risk between the vaccine and no-vaccine cohorts were observed for each outcome, and there was enough evidence (P < .05) to suggest that these differences were attributed to the vaccine. Conclusions: Our data suggest that COVID-19 vaccine is protective against PASC symptoms, new onset of health conditions, and mortality.

The protective effect of covid-19 vaccination on post-acute sequelae of covid-19 (pasc): a multicenter study from a large national health research network

Background COVID-19 vaccines have been proven to decrease the severity of acute phase infection, however little is known about its effect on Post-Acute Sequelae of COVID-19 (PASC). Methods Patients with confirmed COVID-19 diagnosis, minimum age of 18 years with 3 month follow-up post-diagnosis between September 21, 2020 and December 14, 2021 were identified from TriNetX research network platform. The primary outcomes consisted of new onset or persistent symptoms, new onset diagnoses, and death and were compared between vaccine and no-vaccine groups. Results At baseline, 1,578,719 patients with confirmed COVID-19 were identified and 1.6% (n = 25,225) completed vaccination. After matching, there were no differences (p > .05) in demographics or pre-existing comorbidities. At 28 days following COVID diagnosis, the incidence of hypertension was 13.52 per 1000, diabetes was 5.98 per 1000, thyroid disease was 3.80 per 1000, heart disease was 15.41 per 1000, and mental disorders was 14.77 per 1000 in the vaccine cohort. At 90 days following COVID diagnosis, the relative risk of hypertension was 0.33 (95% CI: 0.26, 0.42), diabetes was 0.28 (95% CI: 0.20, 0.38), heart disease was 0.35 (95% CI: 0.29, 0.44), and death was 0.21 (95% CI: 0.16, 0.27). Differences in both 28 and 90-day risk between the vaccine and no-vaccine cohorts were observed for each outcome and there was enough evidence (p < .05) to suggest that these differences were attributed to the vaccine. Conclusion Our data suggest that COVID-19 vaccine is protective against post-acute sequelae of SARS-CoV-2 (PASC) symptoms, new onset of health conditions, and mortality.