ArticleFrontiers in immunology2023
Increase in gut permeability and oxidized ldl is associated with post-acute sequelae of SARS-CoV-2.
Article in Frontiers in immunology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 32 citations in OpenAlex.
- Vitamins K2 and D3 Improve Long COVID, Fungal Translocation, and Inflammation: Randomized Controlled Trial.Nutrients · 2025Trial
- Impact of nutrition on long COVID.Sports medicine and health science · 2026Review
- Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.Cell death & disease · 2026Review
- PANoptosis links gut dysbiosis to obstructive sleep apnea-associated atherosclerosis: a gut-vascular inflammatory axis.Frontiers in immunology · 2026Review
- Fragile mitophagy in long COVID: a proposed recovery-failure endotype for post-exertional malaise.Frontiers in medicine · 2026Article
- Intestinal permeability correlated with chronic fatigue in a patient with long COVID-A case report and overview of the literature.Frontiers in medicine · 2026Article
- Causes of symptoms and symptom persistence in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.Cell reports. Medicine · 2025Review
- Bacteriome Signature in SARS-CoV-2-Infected Patients Correlates with Increased Gut Permeability and Systemic Inflammatory Cytokines.Microorganisms · 2025Article
- Comparable gut mucosal breakdown and microbial translocation in severe COVID-19 with and without HIV infection.AIDS (London, England) · 2025Article
- The Effect of COVID-19 on Arterial Stiffness and Inflammation: A Longitudinal Prospective Study.Viruses · 2025Article
- Pediatric Gastrointestinal Tract Outcomes During the Postacute Phase of COVID-19.JAMA network open · 2025Article
- Synergy Between NK Cells and Monocytes in Potentiating Cardiovascular Disease Risk in Severe COVID-19.Arteriosclerosis, thrombosis, and vascular biology · 2024Article
- The Spectrum of Postacute Sequelae of COVID-19 in Children: From MIS-C to Long COVID.Annual review of virology · 2024Review
- Pediatric Gastrointestinal Outcomes During the Post-Acute Phase of COVID-19: Findings from RECOVER Initiative from 29 Hospitals in the US.medRxiv : the preprint server for health sciences · 2024Article
- Article
- The Long-Term Effect of COVID-19 Infection on Body Composition.Nutrients · 2024Article
- The Multisystem Impact of Long COVID: A Comprehensive Review.Diagnostics (Basel, Switzerland) · 2024Review
- Oxidative stress indexes as biomarkers of the severity in COVID-19 patients.International journal of medical sciences · 2024Article
- The Relationship Between Zonulin and Asthma: A Mouse Model Study.Journal of rhinology : official journal of the Korean Rhinologic Society · 2023Article
- Arterial Stiffness and Oxidized LDL Independently Associated With Post-Acute Sequalae of SARS-CoV-2.Pathogens & immunity · 2023Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
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.
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