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Comprehensive assessments covered clinical, neuropsychiatric, and cognitive functioning, tobacco dependence and exposure, and peripheral biomarkers reflecting neuroendocrine regulation, inflammation, neuroplasticity-related processes, and nicotine metabolism relevant to post-COVID recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both groups exhibited marked clinical, cognitive, and biological alterations following LC; however, recovery trajectories diverged over time. HC showed clear improvement by 12\u00a0months, whereas individuals with TUD showed persistent impairment across clinical and cognitive functioning. Cognitive performance recovered in controls but remained reduced in the TUD group. Biological trajectories paralleled clinical recovery patterns. Dimensional analyses identified two latent components reflecting neuropsychiatric and inflammatory-neurobiological processes. Within the TUD group, 2 recovery-related phenotypes emerged: a persistently impaired subgroup and an adaptive subgroup showing partial recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TUD is associated with impaired and incomplete clinical and biological recovery following LC, beyond smoking exposure alone. These findings emphasize the need for post-COVID care models that integrate tobacco dependence with recovery-related clinical and biological processes, supporting sustained recovery and cessation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>This study shows that tobacco use disorder is associated with incomplete clinical and biological recovery following long COVID, beyond smoking exposure alone and compared to HC. Longitudinal phenotyping revealed heterogeneity in TUD, including a persistently impaired subgroup. Integrating clinical profiles with biological markers may enhance post-COVID monitoring, inform clinical care, and support recovery and cessation outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntag112","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:48:58Z","timestamp":1778845738000},"source":"Crossref","is-referenced-by-count":0,"title":["Divergent long-term recovery after long COVID in tobacco use disorder and healthy controls: a longitudinal study"],"prefix":"10.1093","author":[{"given":"Irina I","family":"Shoshina","sequence":"first","affiliation":[{"name":"Faculty of Psychology, Saint Petersburg State University , Saint Petersburg 199034 ,","place":["Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2176-3907","authenticated-orcid":false,"given":"Thiago P","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Perception, Neuroscience, and Behaviour, Federal University of Paraiba , Joao Pessoa 58051-900 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natanael A","family":"Santos","sequence":"additional","affiliation":[{"name":"Perception, Neuroscience, and Behaviour, Federal University of Paraiba , Joao Pessoa 58051-900 ,","place":["Brazil"]},{"name":"Department of Psychology, Federal University of Paraiba , Joao Pessoa 58051-900 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linnea N","family":"Dahlgren","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurology, Ixelles, Belgium , 1050 Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"2026061716512311800_ref1","doi-asserted-by":"publisher","first-page":"2337","DOI":"10.1016\/S0140-6736(21)01169-7","article-title":"GBD 2019 Tobacco Collaborators. 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