{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:07:43Z","timestamp":1789517263381,"version":"build-2803163510"},"reference-count":52,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Par\u00e1 Secretariat for Science, Technology and Higher, Professional and Technological Education","award":["09\/2021"],"award-info":[{"award-number":["09\/2021"]}]},{"name":"Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil","award":["13\/2020"],"award-info":[{"award-number":["13\/2020"]}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"crossref","award":["406360\/2022"],"award-info":[{"award-number":["406360\/2022"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"award":["406360\/2022"],"award-info":[{"award-number":["406360\/2022"]}],"id":[{"id":"https:\/\/ror.org\/03swz6y49","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Post-COVID-19 syndrome (PCS) can persist even after mild acute illness, and oxidative stress has been proposed as a central mechanism for this persistence, although it remains poorly studied in the Amazon. This study characterized redox imbalance in patients with PCS through a combined analysis of lipid peroxidation, antioxidant defenses, and nitric oxide bioavailability. In a cross-sectional observational design, 85 patients with PCS and 53 healthy controls were evaluated, with determination of TBARS, total antioxidant capacity (ABTS), erythrocyte SOD, CAT, and GPx activity, plasma nitric oxide levels, and subgroup analysis according to disease duration (\u22646, 6\u201312, and &gt;12 months). Patients with PCS showed significantly higher TBARS concentrations and lower nitric oxide, ABTS, SOD, CAT, and GPx levels than controls, with predominantly large effect sizes. Lipid peroxidation correlated positively with HDL-c levels, and none of the markers differed significantly among the symptom duration subgroups. The findings indicate that PCS is associated with a persistent redox imbalance, marked by continuous lipid oxidative damage and sustained depletion of enzymatic and non-enzymatic antioxidant defenses, with a vascular component suggested by reduced nitric oxide levels, regardless of the time elapsed since symptom onset.<\/jats:p>","DOI":"10.3390\/antiox15081013","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T08:08:29Z","timestamp":1786694909000},"page":"1013","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Persistent Redox Imbalance in Post-COVID-19 Syndrome: Lipid Peroxidation, Antioxidant Enzyme Depletion, and Reduced Nitric Oxide Availability in an Amazonian Population"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6056-7880","authenticated-orcid":false,"given":"Renata Cunha","family":"Silva","sequence":"first","affiliation":[{"name":"Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases in the Amazon, State University of Par\u00e1, Bel\u00e9m 66095-662, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juarez Ant\u00f4nio Sim\u00f5es","family":"Quaresma","sequence":"additional","affiliation":[{"name":"Department of Pathology, Escola Paulista de Medicina, Federal University of S\u00e3o Paulo, S\u00e3o Paulo 04023-062, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Kenji Hosoda","family":"Mineshita","sequence":"additional","affiliation":[{"name":"Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases in the Amazon, State University of Par\u00e1, Bel\u00e9m 66095-662, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00edrha Eduarda Alc\u00e2ntara","family":"Costa","sequence":"additional","affiliation":[{"name":"Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases in the Amazon, Federal University of Par\u00e1, Bel\u00e9m 66075-110, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f4nica Myrna Cordeiro","family":"Reis","sequence":"additional","affiliation":[{"name":"Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases in the Amazon, Federal Rural University of the Amazon, Bel\u00e9m 66077-830, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2186-5703","authenticated-orcid":false,"given":"Camile Irene Mota da","family":"Silva","sequence":"additional","affiliation":[{"name":"Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases in the Amazon, State University of Par\u00e1, Bel\u00e9m 66095-662, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6465-5548","authenticated-orcid":false,"given":"Rebeca Fontenele","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Molecular Biology Laboratory (LABIOMOL), Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Gabriel Viana","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Laboratory of Natural Products Chemistry, Federal University of Par\u00e1, Bel\u00e9m 66075-110, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathellen Joane Silva","family":"Miranda","sequence":"additional","affiliation":[{"name":"Laboratory of Natural Products Chemistry, Metropolitan University Center of the Amazon (UNIFAMAZ), Bel\u00e9m 66053-000, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elem Cristina Rodrigues","family":"Chaves","sequence":"additional","affiliation":[{"name":"Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases in the Amazon, State University of Par\u00e1, Bel\u00e9m 66095-662, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Carvalho de","family":"Menezes","sequence":"additional","affiliation":[{"name":"Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases in the Amazon, State University of Par\u00e1, Bel\u00e9m 66095-662, PA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0568-7177","authenticated-orcid":false,"given":"Jofre Jacob da Silva","family":"Freitas","sequence":"additional","affiliation":[{"name":"Center for Pre-Clinical Studies of the Amazon, State University of Par\u00e1, Bel\u00e9m 66095-662, PA, 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