{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:32:30Z","timestamp":1788226350361,"version":"build-2803163510"},"reference-count":54,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Post\u2010COVID Syndrome (PCS) is the term for a condition with persistent symptoms in a proportion of COVID\u201019 patients after asymptomatic, mild, or severe disease courses. Numbers vary, but the current estimate is that after COVID\u201019 approximately 10% develop PCS. The aim of our study was to evaluate the impact of SARS\u2010CoV\u20102 infection on the gastrointestinal (GI) tract and associations with the development of PCS with fatigue, post\u2010exertional malaise (PEM), orthostatic dysregulation, autonomous dysregulation, and\/or neurocognitive dysregulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>By combining medical record data from a prospective observational study with symptom analysis before, during, and after SARS\u2010CoV\u20102 infection, we aimed to identify potential risk factors and predictive markers for PCS. Additionally, we analyzed blood, saliva, and stool samples from this well\u2010characterized PCS patient cohort to biologically validate our findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified significant associations between pre\u2010existing GI complaints and the development of PCS Fatigue. PCS patients showed higher LBP\/sCD14 ratios, lower IL\u201033 levels, and higher IL\u20106 levels compared to control groups. Our results highlight the critical role of the GI tract in PCS development of post\u2010viral Fatigue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We propose that the viral infection disrupts pathways related to the innate immune response and GI barrier function, evidenced by intestinal low\u2010grade inflammation and GI barrier leakage. Monitoring GI symptoms and markers before, during, and after SARS\u2010CoV\u20102 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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.16593","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T09:13:55Z","timestamp":1747300435000},"page":"2610-2621","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Gastrointestinal Barrier Disruption in Post\u2010<scp>COVID<\/scp> Syndrome Fatigue Patients"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-2099","authenticated-orcid":false,"given":"Johanna","family":"Rohrhofer","sequence":"first","affiliation":[{"name":"Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna  Vienna 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