Evidence map›Paper›PMID 40721715›Full record

ArticleScientific reports2025

Sex differences in inflammation and markers of gut integrity in long COVID.

Jared C Durieux, Ziad Koberssy, Joviane Daher, Jhony Baissary, Marc Abboud, Ornina Atieh, Christopher Woolverton, Grace A McComsey

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jared C DurieuxClinical Research Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. jdurieux@kent.edu.
Ziad KoberssySchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Joviane DaherSchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Jhony BaissarySchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Marc AbboudFaculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Ornina AtiehSchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Christopher WoolvertonCollege of Public Health, Kent State University, Kent, OH, USA.
Grace A McComseySchool of Medicine, Case Western Reserve University, Cleveland, OH, USA. gam9@case.edu.

Funding

Clinical and Translational Science Collaborative of Northern Ohio, Catalyzing Linkages to Equity in Health (CLE Health)UM1TR004528 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI GRACE A MCCOMSEY · 2023 to 2026
$32.1M
The Cleveland Digestive Diseases Research Core Center (DDRCC)P30DK097948 · NIDDK · CASE WESTERN RESERVE UNIVERSITY · PI Fabio Cominelli · 2015 to 2026
$15.6M
Clinical and Translational Science Collaborative of Northern Ohio, funded by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health UM1TR004528NCATS NIH HHS UM1 TR004528NIDDK NIH HHS P30 DK097948
6 · The paper itself

Abstract

Endothelial damage represents an essential pathogenic mechanism of respiratory and multiorgan dysfunction as seen in the post-acute phase of COVID-19. Biological differences between male and female sex, inflammation, and gut integrity may have an integral role in endothelial damage and explain the residual effects of COVID-19 infection in long COVID, yet evidence is limited. Confirmed COVID-19 negative participants were 1:1 propensity-score matched to COVID-19 positive participants. Symptoms occurring at least one-month following COVID-infection and lasting more than three-months was defined as long COVID. Measures of endothelial function included reactive hyperemic index (RHI ≥ 1.67 = normal endothelial function) and augmentation index (higher AIx = worse arterial elasticity). A total of 89 COVID-19 negative participants was matched to 89 COVID-19 positive participants. Among the COVID-19 survivors, the median age was 42.92 years, 46.07% were female sex, and 57 (64%) had long COVID. Higher levels of inflammation (TNF-RI and oxLDL) and gut integrity (zonulin and BDG) was associated (P < 0.05) with a two-fold increase in the odds of long COVID. Female sex, independent of COVID-19 status, was 4x more likely to have worse AIx (P < 0.0001) compared to male sex. Among female sex with long COVID, higher levels of inflammation (IL-6, VCAM, hsCRP) and gut integrity (zonulin) was independently associated (P < 0.05) with higher AIx. Female sex with long COVID symptoms had the worse inflammation, gut integrity, and arterial stiffness among COVID-19 survivors. This reinforces the importance of continued, long-term follow-up care following COVID-19 infection, with special attention needed for female sex who may be at a higher cardiovascular disease risk.

Indexed as

COVID-19InflammationAdultBiomarkersFemaleHumansMaleMiddle AgedSARS-CoV-2Sex CharacteristicsSex FactorsBiomarkersArterial stiffnessCOVID-19Endothelial dysfunctionGut integrityInflammationLong COVIDLong COVID symptomsSex differences

Identifiers

PMID40721715
PMCPMC12304274

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.