{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:44:17Z","timestamp":1790181857889,"version":"4.1.0"},"reference-count":82,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      During the global rollout of COVID-19 vaccines, a subset of individuals reported persistent symptoms following vaccination, with clinical presentations overlapping those of Long COVID and requiring individualised treatment strategies. Distinguishing between vaccine-related adverse events and post-infectious sequelae is challenging, particularly given the potential for unrecognised asymptomatic or mild SARS-CoV-2 infection before or after vaccination. To address this complexity, we defined our disease cohort as individuals experiencing persistent symptoms (\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"im1\">\n                          <mml:mo>\u2265<\/mml:mo>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      12 weeks) following SARS-CoV-2 vaccination, without a confirmed history of prolonged symptoms after acute infection; for clarity, we refer to this group as presenting with Post-Vaccination\/Post-Infection Syndrome (PV\/PIS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, we conducted a plasma proteomic analysis of digested microclot deposits isolated from platelet-poor plasma samples of 14 individuals with PV\/PIS compared to 16 healthy controls, using liquid-chromatography-mass spectrometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified significant alterations in coagulation factors, acute phase proteins, and immune response modulators in the PV\/PIS group compared to controls. Notably, elevated levels of serum amyloid A1 and A2, attractin, and coagulation factors X and XI were observed, alongside downregulation of immune-regulatory proteins. These findings suggest that PV\/PIS is characterised by persistent immune dysregulation and coagulopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This proteomic signature was found to only partially overlap with that previously reported in a proteomics analysis on Long COVID samples, collected prior to vaccination availability. Our results highlight the complex interplay between immune activation, endothelial dysfunction, and coagulation pathologies in PV\/PIS, with distinct differences detected between these systems in Long COVID and PV\/PIS, paving the way for more targeted protein research in these conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1753348","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:48:09Z","timestamp":1774421289000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Proteomic signatures of COVID-19 Post-Vaccination\/Post-Infection Syndrome (PV\/PIS): insights into immune dysregulation and coagulopathy"],"prefix":"10.3389","volume":"16","author":[{"given":"Maxine","family":"Waters","sequence":"first","affiliation":[{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University","place":["Stellenbosch, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mare","family":"Vlok","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University","place":["Stellenbosch, South Africa"]},{"name":"Trace Labs (PTY) LTD","place":["Loevenstein, Cape Town, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elouise E.","family":"Kroon","sequence":"additional","affiliation":[{"name":"South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University","place":["Cape Town, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maritha J.","family":"Kotze","sequence":"additional","affiliation":[{"name":"Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive","place":["Tygerberg, Cape Town, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelebogile E.","family":"Moremi","sequence":"additional","affiliation":[{"name":"Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive","place":["Tygerberg, Cape Town, South Africa"]},{"name":"Division of Chemical Pathology, Department of Pathology, National Health Laboratory Service, Tygerberg Hospital","place":["Cape Town, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunday O.","family":"Oladejo","sequence":"additional","affiliation":[{"name":"School for Data Science and Computational Thinking, Stellenbosch University","place":["Stellenbosch, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanshukan","family":"Rajaratnam","sequence":"additional","affiliation":[{"name":"School for Data Science and Computational Thinking, Stellenbosch University","place":["Stellenbosch, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean M.","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University","place":["Stellenbosch, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantelle","family":"Venter","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University","place":["Stellenbosch, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantelle J.","family":"Scott","sequence":"additional","affiliation":[{"name":"Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive","place":["Tygerberg, Cape Town, South Africa"]},{"name":"School for Data Science and Computational Thinking, Stellenbosch University","place":["Stellenbosch, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas B.","family":"Kell","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University","place":["Stellenbosch, South Africa"]},{"name":"Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool","place":["Liverpool, United Kingdom"]},{"name":"The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark","place":["Kongens Lyngby, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etheresia","family":"Pretorius","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences, Faculty of Science, Stellenbosch University","place":["Stellenbosch, South Africa"]},{"name":"Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool","place":["Liverpool, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-30583-2","article-title":"A prospective cohort study assessing the relationship between long-covid symptom incidence in covid-19 patients and covid-19 vaccination","volume":"13","author":"Abu Hamdh","year":"2023","journal-title":"Sci. Rep."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/953461","article-title":"Acute phase reactants as novel predictors of cardiovascular disease","volume":"2012","author":"Ahmed","year":"2012","journal-title":"ISRN Inflammation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1097\/moh.0000000000000368","article-title":"Interactions of B-amyloid peptide with fibrinogen and coagulation factor xii may contribute to alzheimer\u2019s disease","volume":"24","author":"Ahn","year":"2017","journal-title":"Curr. Opin. Hematol."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.4110\/in.2022.22.e46","article-title":"Context-dependent regulation of type17 immunity by microbiota at the intestinal barrier","volume":"22","author":"Akuzum","year":"2022","journal-title":"Immune Netw."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.1038\/s41591-024-03173-6","article-title":"Long covid science, research and policy","volume":"30","author":"Al-Aly","year":"2024","journal-title":"Nat. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1126\/science.adl0867","article-title":"Solving the puzzle of long covid","volume":"383","author":"Al-Aly","year":"2024","journal-title":"Science"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-023-00904-7","article-title":"The immunology of long covid","volume":"23","author":"Altmann","year":"2023","journal-title":"Nat. Rev. Immunol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.bbrc.2018.04.198","article-title":"A\u03b21\u201340 mediated aggregation of proteins and metabolites unveils the relevance of amyloid cross-seeding in amyloidogenesis","volume":"501","author":"Anand","year":"2018","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"B9","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1038\/s41541-021-00396-3","article-title":"Distinct sars-cov-2 antibody reactivity patterns elicited by natural infection and mrna vaccination","volume":"6","author":"Assis","year":"2021","journal-title":"NPJ Vaccines"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fmolb.2021.632290","article-title":"Circulating exosomes are strongly involved in sars-cov-2 infection","volume":"8","author":"Barberis","year":"2021","journal-title":"Front. Mol. Biosci."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1056\/NEJMra2206573","article-title":"Covid-19 vaccines - immunity, variants, boosters","volume":"387","author":"Barouch","year":"2022","journal-title":"N Engl. J. Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.1038\/s41591-023-02521-2","article-title":"Postacute sequelae of covid-19 at 2 years","volume":"29","author":"Bowe","year":"2023","journal-title":"Nat. Med."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed-2022-000385","article-title":"Effect of covid-19 vaccination on long covid: systematic review","volume":"2","author":"Byambasuren O","year":"2023","journal-title":"BMJ Med."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.113426","article-title":"How and why patients made long covid","volume":"268","author":"Callard","year":"2021","journal-title":"Soc. Sci. Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1055\/a-1788-5206","article-title":"Assessing clinically meaningful hypercoagulability after covid-19 vaccination: A longitudinal study","volume":"122","author":"Campello","year":"2022","journal-title":"Thromb. Haemost."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58010028","article-title":"Orthostatic symptoms and reductions in cerebral blood flow in long-haul covid-19 patients: similarities with myalgic encephalomyelitis\/chronic fatigue syndrome","volume":"58","author":"Campen","year":"2021","journal-title":"Med. (Kaunas)"},{"key":"B17","unstructured":"Long covid or post-covid conditions\n          \n          2024"},{"key":"B18","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1172\/jci74231","article-title":"An unexpected role for platelets in blocking th17 differentiation","volume":"124","author":"Chakraverty","year":"2014","journal-title":"J. Clin. Invest."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2019.100937","article-title":"Amyloid cross-seeding raises new dimensions to understanding of amyloidogenesis mechanism","volume":"56","author":"Chaudhuri","year":"2019","journal-title":"Ageing Res. Rev."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2110","DOI":"10.1111\/jth.14981","article-title":"Covid-19: A collision of complement, coagulation and inflammatory pathways","volume":"18","author":"Chauhan","year":"2020","journal-title":"J. Thromb. Haemost."},{"key":"B21","doi-asserted-by":"publisher","first-page":"962","DOI":"10.3390\/ijms25020962","article-title":"Pamps and damps in sepsis: A review of their molecular features and potential clinical implications","volume":"25","author":"Cicchinelli","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines12010103","article-title":"Host genetic variation impacts sars-cov-2 vaccination response in the diversity outbred mouse population","volume":"12","author":"Cruz Cisneros","year":"2024","journal-title":"Vaccines (Basel)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.101019","article-title":"Characterizing long covid in an international cohort: 7 months of symptoms and their impact","volume":"38","author":"Davis","year":"2021","journal-title":"eClinicalMedicine"},{"key":"B24","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long covid: major findings, mechanisms and recommendations","volume":"21","author":"Davis","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24065944","article-title":"Mrna vaccines against sars-cov-2: advantages and caveats","volume":"24","author":"Echaide","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14184464","article-title":"Immune profiling uncovers memory T-cell responses with a th17 signature in cancer patients with previous sars-cov-2 infection followed by mrna vaccination","volume":"14","author":"Echaide","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B27","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12941-025-00793-9","article-title":"Long covid clinical evaluation, research and impact on society: A global expert consensus","volume":"24","author":"Ewing","year":"2025","journal-title":"Ann. Clin. Microbiol. Antimicrob"},{"key":"B28","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1056\/NEJMoa2116597","article-title":"Effect of covid-19 vaccination on transmission of alpha and delta variants","volume":"386","author":"Eyre David","year":"2022","journal-title":"New Engl. J. Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1055\/s-0042-1756306","article-title":"Relative hypercoagulopathy of the sars-cov-2 beta and delta variants when compared to the less severe omicron variants is related to teg parameters, the extent of fibrin amyloid microclots, and the severity of clinical illness","volume":"48","author":"Grobbelaar","year":"2022","journal-title":"Semin. Thromb. Hemost"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1042\/bsr20210611","article-title":"Sars-cov-2 spike protein S1 induces fibrin(Ogen) resistant to fibrinolysis: implications for microclot formation in covid-19","volume":"41","author":"Grobbelaar Lize","year":"2021","journal-title":"Biosci Rep."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1631\/jzus.2005.B1045","article-title":"Acute phase reaction and acute phase proteins","volume":"6","author":"Gruys","year":"2005","journal-title":"J. Zhejiang Univ Sci. B"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e70019","DOI":"10.1002\/cph4.70019","article-title":"Mechanistic insights into long covid: viral persistence, immune dysregulation, and multi-organ dysfunction","volume":"15","author":"Gupta","year":"2025","journal-title":"Compr. Physiol."},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-8-25","article-title":"Frequent expression loss of inter-alpha-trypsin inhibitor heavy chain (Itih) genes in multiple human solid tumors: A systematic expression analysis","volume":"8","author":"Hamm","year":"2008","journal-title":"BMC Cancer"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e0179623","DOI":"10.1128\/spectrum.01796-23","article-title":"Distinguishing sars-cov-2 infection and vaccine responses up to 18 months post-infection using nucleocapsid protein and receptor-binding domain antibodies","volume":"11","author":"Jarlhelt","year":"2023","journal-title":"Microbiol. Spectr."},{"key":"B35","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.preghy.2021.07.248","article-title":"Who said differentiating preeclampsia from covid-19 infection was easy","volume":"26","author":"Jayaram","year":"2021","journal-title":"Preg Hypertens."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/5069614","article-title":"Plasma inter-alpha-trypsin inhibitor heavy chains H3 and H4 serve as novel diagnostic biomarkers in human colorectal cancer","volume":"2019","author":"Jiang","year":"2019","journal-title":"Dis. Markers"},{"key":"B37","doi-asserted-by":"publisher","first-page":"5473","DOI":"10.1039\/C9CS00199A","article-title":"Half a century of amyloids: past, present and future","volume":"49","author":"Ke","year":"2020","journal-title":"Chem. Soc. Rev."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2016.00060","article-title":"A dormant microbial component in the development of preeclampsia","volume":"3","author":"Kell","year":"2016","journal-title":"Front. Med. (Laus)"},{"key":"B39","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.pbiomolbio.2016.08.006","article-title":"Proteins behaving badly. Substoichiometric molecular control and amplification of the initiation and nature of amyloid fibril formation: lessons from and for blood clotting","volume":"123","author":"Kell","year":"2017","journal-title":"Prog. Biophys. Mol. Biol."},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3390\/ijms251910809","article-title":"Proteomic evidence for amyloidogenic cross-seeding in fibrinaloid microclots","volume":"25","author":"Kell","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"B41","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.1038\/s12276-022-00895-w","article-title":"Inflammation promotes synucleinopathy propagation","volume":"54","author":"Kim","year":"2022","journal-title":"Exp. Mol. Med."},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-022-01623-4","article-title":"Proteomics of fibrin amyloid microclots in long covid\/post-acute sequelae of covid-19 (Pasc) shows many entrapped pro-inflammatory molecules that may also contribute to a failed fibrinolytic system","volume":"21","author":"Kruger","year":"2022","journal-title":"Cardiovasc. Diabetol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.cell.2019.11.026","article-title":"Serum amyloid a proteins induce pathogenic th17 cells and promote inflammatory disease","volume":"180","author":"Lee","year":"2020","journal-title":"Cell"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac124","article-title":"Covid-19 vaccines and sars-cov-2 transmission in the era of new variants: A review and perspective","volume":"9","author":"Marcelin","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.3390\/cells10061550","article-title":"The role of th17 response in covid-19","volume":"10","author":"Martonik","year":"2021","journal-title":"Cells"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1544085","article-title":"Balancing inflammation: the specific roles of serum amyloid a proteins in sterile and infectious diseases","volume":"16","author":"Mohanty","year":"2025","journal-title":"Front. Immunol."},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.833650","article-title":"Orthostatic intolerance in adults reporting long covid symptoms was not associated with postural orthostatic tachycardia syndrome","volume":"13","author":"Monaghan","year":"2022","journal-title":"Front. Physiol."},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-023-02250-0","article-title":"A systematic review and meta-analysis of long covid symptoms","volume":"12","author":"Natarajan","year":"2023","journal-title":"System Rev."},{"key":"B49","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1016\/j.jtha.2023.04.039","article-title":"Thromboinflammation in long covid\u2014the elusive key to postinfection sequelae","volume":"21","author":"Nicolai","year":"2023","journal-title":"J. Thromb. Haemost"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2025.106436","article-title":"Characterising the sars-cov-2 nucleocapsid (N) protein antibody response","volume":"90","author":"Noble","year":"2025","journal-title":"J. Infect."},{"key":"B51","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s12933-024-02315-x","article-title":"Data-independent lc-ms\/ms analysis of me\/cfs plasma reveals a dysregulated coagulation system, endothelial dysfunction, downregulation of complement machinery","volume":"23","author":"Nunes","year":"2024","journal-title":"Cardiovasc. Diabetol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"3102","DOI":"10.1038\/s41598-019-39056-x","article-title":"Serum amyloid a binds to fibrin(Ogen), promoting fibrin amyloid formation","volume":"9","author":"Page","year":"2019","journal-title":"Sci. Rep."},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aba7381","article-title":"Itih4 acts as a protease inhibitor by a novel inhibitory mechanism","volume":"7","author":"Pihl","year":"2021","journal-title":"Sci. Adv."},{"key":"B54","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s12933-017-0624-5","article-title":"Substantial fibrin amyloidogenesis in type 2 diabetes assessed using amyloid-selective fluorescent stains","volume":"16","author":"Pretorius","year":"2017","journal-title":"Cardiovasc. Diabetol."},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-020-01165-7","article-title":"Prevalence of readily detected amyloid blood clots in \u2018Unclotted\u2019 Type 2 diabetes mellitus and covid-19 plasma: A preliminary report","volume":"19","author":"Pretorius","year":"2020","journal-title":"Cardiovasc. Diabetol."},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-021-01359-7","article-title":"Persistent clotting protein pathology in long covid\/post-acute sequelae of covid-19 (Pasc) is accompanied by increased levels of antiplasmin","volume":"20","author":"Pretorius","year":"2021","journal-title":"Cardiovasc. Diabetol."},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.698169","article-title":"Long covid or post-acute sequelae of covid-19 (Pasc): an overview of biological factors that may contribute to persistent symptoms","volume":"12","author":"Proal","year":"2021","journal-title":"Front. Microbiol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.dsx.2020.12.025","article-title":"Long covid-19: challenges in the diagnosis and proposed diagnostic criteria","volume":"15","author":"Raveendran","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"B59","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1080\/00207454.2020.1860038","article-title":"Fibrinogen isoforms as potential blood-based biomarkers of alzheimer\u2019s disease using a proteomics approach","volume":"132","author":"Rehiman","year":"2022","journal-title":"Int. J. Neurosci."},{"key":"B60","doi-asserted-by":"publisher","first-page":"22777","DOI":"10.1038\/s41598-021-02321-z","article-title":"Comparing the clinical efficacy of covid-19 vaccines: A systematic review and network meta-analysis","volume":"11","author":"Rotshild","year":"2021","journal-title":"Sci. Rep."},{"key":"B61","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s10020-018-0047-0","article-title":"Serum amyloid a - a review","volume":"24","author":"Sack","year":"2018","journal-title":"Mol. Med."},{"key":"B62","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/978-3-030-41769-7_17","article-title":"Serum amyloid a (Saa) proteins","volume":"94","author":"Sack","year":"2020","journal-title":"Subcell Biochem."},{"key":"B63","doi-asserted-by":"publisher","first-page":"2499","DOI":"10.1182\/bloodadvances.2023012473","article-title":"Microclots, as defined by amyloid-fibrinogen aggregates, predict risks of disseminated intravascular coagulation and mortality","volume":"8","author":"Schofield","year":"2024","journal-title":"Blood Adv."},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2023.154497","article-title":"Covid-19, post-acute covid-19 syndrome (Pacs, \u201cLong covid\u201d) and post-covid-19 vaccination syndrome (Pcvs, \u201cPost-covidvac-syndrome\u201d): similarities and differences","volume":"246","author":"Scholkmann","year":"2023","journal-title":"Pathol. - Res. Pract."},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11102813","article-title":"Blood coagulation and thrombotic disorders following sars-cov-2 infection and covid-19 vaccination","volume":"11","author":"Sekulovski","year":"2023","journal-title":"Biomedicines"},{"key":"B66","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.3390\/jcm14061966","article-title":"Severely ill covid-19 patients may exhibit hypercoagulability despite escalated anticoagulation","volume":"14","author":"Shakhidzhanov","year":"2025","journal-title":"J. Clin. Med."},{"key":"B67","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1172\/jci71858","article-title":"Platelet factor 4 limits th17 differentiation and cardiac allograft rejection","volume":"124","author":"Shi","year":"2014","journal-title":"J. Clin. Invest."},{"key":"B68","doi-asserted-by":"publisher","first-page":"561","DOI":"10.3390\/idr16040042","article-title":"Persistent vascular complications in long covid: the role of ace2 deactivation, microclots, and uniform fibrosis","volume":"16","author":"Sideratou","year":"2024","journal-title":"Infect. Dis. Rep."},{"key":"B69","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1038\/s43856-024-00657-x","article-title":"A 24-month national cohort study examining long-term effects of covid-19 in children and young people","volume":"4","author":"Stephenson","year":"2024","journal-title":"Commun. Med."},{"key":"B70","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1038\/s41591-022-01909-w","article-title":"Symptoms and risk factors for long covid in non-hospitalized adults","volume":"28","author":"Subramanian","year":"2022","journal-title":"Nat. Med."},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.761382","article-title":"Role of exercise intensity on th1\/th2 immune modulations during the covid-19 pandemic","volume":"12","author":"Supriya","year":"2021","journal-title":"Front. Immunol."},{"key":"B72","doi-asserted-by":"publisher","first-page":"e000229","DOI":"10.1136\/bmjmed-2022-000229","article-title":"Efficacy of first dose of covid-19 vaccine versus no vaccination on symptoms of patients with long covid: target trial emulation based on compare E-cohort","volume":"2","author":"Tran","year":"2023","journal-title":"BMJ Med."},{"key":"B73","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.tem.2023.03.002","article-title":"Long covid: pathophysiological factors and abnormalities of coagulation","volume":"34","author":"Turner","year":"2023","journal-title":"Trends Endocrinol. Metab."},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10102058","article-title":"Orthostatic intolerance in long-haul covid after sars-cov-2: A case-control comparison with post-ebv and insidious-onset myalgic encephalomyelitis\/chronic fatigue syndrome patients","volume":"10","author":"van Campen","year":"2022","journal-title":"Healthc (Basel)"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21218234","article-title":"Erythrocyte, platelet, serum ferritin, and P-selectin pathophysiology implicated in severe hypercoagulation and vascular complications in covid-19","volume":"21","author":"Venter","year":"2020","journal-title":"Int. J. Mol. Sci."},{"key":"B76","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s12964-023-01397-6","article-title":"Sars-cov-2\u2009S protein activates nlrp3 inflammasome and deregulates coagulation factors in endothelial and immune cells","volume":"22","author":"Villacampa","year":"2024","journal-title":"Cell Comm Signaling"},{"key":"B77","doi-asserted-by":"publisher","first-page":"2067","DOI":"10.1038\/jid.2012.112","article-title":"Chronic skin-specific inflammation promotes vascular inflammation and thrombosis","volume":"132","author":"Wang","year":"2012","journal-title":"J. Invest. Dermatol."},{"key":"B78","unstructured":"Post covid-19 condition (Long covid)\n          \n          2022"},{"key":"B79","unstructured":"Covid-19 vaccination, world data\n          \n          2024"},{"key":"B80","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (Covid-19): A review","volume":"324","author":"Wiersinga","year":"2020","journal-title":"JAMA"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1432224","article-title":"The function of the inter-alpha-trypsin inhibitors in the development of disease","volume":"11","author":"Zhang","year":"2024","journal-title":"Front. Med. (Laus)"},{"key":"B82","doi-asserted-by":"publisher","first-page":"447","DOI":"10.59249\/pmie8461","article-title":"The intestine in acute and long covid: pathophysiological insights and key lessons","volume":"97","author":"Zollner","year":"2024","journal-title":"Yale J. Biol. Med."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1753348\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:48:14Z","timestamp":1774421294000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1753348\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":82,"alternative-id":["10.3389\/fcimb.2026.1753348"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1753348","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1753348"}}