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

Publication date: Jul 28, 2025

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 

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Concepts Keywords
Aix Arterial stiffness
Endothelial COVID-19
Month Endothelial dysfunction
Pathogenic Gut integrity
Sex Inflammation
Long COVID
Long COVID symptoms
Sex differences

Semantics

Type Source Name
disease MESH inflammation
disease MESH long COVID
disease MESH COVID-19
disease IDO role
disease MESH infection
disease MESH Arterial stiffness

Original Article

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