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Gastrointestinal Barrier Disruption in Post-COVID Syndrome Fatigue Patients, 2025, Rohrhofer et al.

Discussion in 'Long Covid research' started by SNT Gatchaman, May 16, 2025.

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  1. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    Gastrointestinal Barrier Disruption in Post-COVID Syndrome Fatigue Patients
    Johanna Rohrhofer; Viktoria Wolflehner; Johannes Schweighardt; Larissa Koidl; Michael Stingl; Sonja Zehetmayer; Joana Séneca; Petra Pjevac; Eva Untersmayr

    BACKGROUND
    Post-COVID Syndrome (PCS) is the term for a condition with persistent symptoms in a proportion of COVID-19 patients after asymptomatic, mild, or severe disease courses. Numbers vary, but the current estimate is that after COVID-19 approximately 10% develop PCS. The aim of our study was to evaluate the impact of SARS-CoV-2 infection on the gastrointestinal (GI) tract and associations with the development of PCS with fatigue, post-exertional malaise (PEM), orthostatic dysregulation, autonomous dysregulation, and/or neurocognitive dysregulation.

    METHODS
    By combining medical record data from a prospective observational study with symptom analysis before, during, and after SARS-CoV-2 infection, we aimed to identify potential risk factors and predictive markers for PCS. Additionally, we analyzed blood, saliva, and stool samples from this well-characterized PCS patient cohort to biologically validate our findings.

    RESULTS
    We identified significant associations between pre-existing GI complaints and the development of PCS Fatigue. PCS patients showed higher LBP/sCD14 ratios, lower IL-33 levels, and higher IL-6 levels compared to control groups. Our results highlight the critical role of the GI tract in PCS development of post-viral Fatigue.

    CONCLUSION
    We propose that the viral infection disrupts pathways related to the innate immune response and GI barrier function, evidenced by intestinal low-grade inflammation and GI barrier leakage. Monitoring GI symptoms and markers before, during, and after SARS-CoV-2 infection is crucial for identifying predictive clinical phenotypes in PCS. Understanding the interaction between viral infections, immune responses, and gut integrity could lead to more effective diagnostic and treatment strategies, ultimately reducing the burden on PCS patients.

    Link | PDF (Allergy) [Open Access]
     
    SNT Gatchaman, May 16, 2025
    #1
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  2. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    SNT Gatchaman, May 17, 2025
    #2
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  3. Hutan

    Hutan Moderator Staff Member

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    It's nicely written up and each group, although small, is well matched.

    Table 2 of pre-existing complaints is interesting.
    So, the 'before' is just before Covid-19 or 'general health status', so it's not pre-ME/CFS for the ME/CFS group, it's after ME/CFS onset. That makes some figures in Table 2 less useful for comparisons.

    POTS was reported by no PCS Fatigue group members, and only 37.5% (6) of the ME/CFS group.
    50% of PCS-Fatigue people reported pre-existing GI symptoms before Covid-19; but only around 20% (3) of the ME/CFS group reported having GI symptoms - that was about the same percentage as the non-PCS Covid-19 group.
     
    Hutan, May 17, 2025
    #3
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  4. Dolphin

    Dolphin Senior Member (Voting Rights)

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    https://www.eurekalert.org/news-releases/1084706

    News Release 21-May-2025
    Post-COVID syndrome: connection between gut health and fatigue

    Central role of the gastrointestinal tract in the development of long-term consequences after COVID-19

    Peer-Reviewed Publication
    Medical University of Vienna

    In a recent study, a research team from the Medical University of Vienna has gained new insights into post-COVID syndrome (PCS) and the relevance of a healthy gastrointestinal tract. The study, which was recently published in the journal Allergy, shows that PCS patients have altered inflammatory markers and a disturbed intestinal barrier, which could contribute to the development of post-viral fatigue.

    The researchers, led by Eva Untersmayr-Elsenhuber from MedUni Vienna's Center for Pathophysiology, Infectiology and Immunology, analyzed data from a prospective observational study. The course of SARS-CoV-2 infections and gastrointestinal symptoms before, during and after the infection were examined. In addition, blood, saliva and stool samples from PCS patients were analyzed.

    The results show that patients with pre-existing gastrointestinal complaints have an increased risk of developing PCS fatigue. At the same time, prominent changes were found in certain biomarkers. For example, PCS patients showed an increased LBP/sCD14 ratio and lower IL-33 levels, which indicates altered immune activation and a reduced intestinal barrier. In addition, there were increased IL-6 levels, which are considered a marker for systemic inflammatory reactions.

    "Our results suggest that SARS-CoV-2 infection can have long-term effects on the immune system and intestinal health that contribute to the development of PCS," explains Eva Untersmayr-Elsenhuber. She is co-director of the National Reference Center for Postviral Syndromes at MedUni Vienna.

    Developing targeted treatment strategies
    The study underlines the central role of the gastrointestinal tract in the development of long-term consequences after COVID-19. Monitoring gastrointestinal symptoms and biomarkers could help to identify at-risk patients at an early stage and develop targeted treatment strategies. This could be particularly important for the treatment of post-viral fatigue.

    "What is particularly exciting is that our study participants were mostly young and healthy before the infection. Even the Covid disease was mostly mild or even asymptomatic. One difference was the more frequently reported gastrointestinal complaints in the group that developed post-viral fatigue," explains Johanna Rohrhofer from the Center for Pathophysiology Infectiology and Immunology, lead author of the study.
    The research team plans to validate the findings in further studies. "The identification of predictive markers for PCS could enable personalized prevention and treatment in the future," says Eva Untersmayr-Elsenhuber.

    Journal
    Allergy

    DOI
    10.1111/all.16593

    Article Title
    Gastrointestinal Barrier Disruption in Post-COVID Syndrome Fatigue Patients

    Article Publication Date
    15-May-2025

     
    Dolphin, May 23, 2025
    #4
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