Vaccination and food consumption: association with Post-Acute COVID-19 Syndrome in Brazilian adults (CUME Study)

DOI record: { "DOI": "10.3389/fnut.2025.1549747", "ISSN": [ "2296-861X" ], "URL": "http://dx.doi.org/10.3389/fnut.2025.1549747", "abstract": "<jats:sec><jats:title>Background</jats:title><jats:p>Post-Acute COVID-19 Syndrome (PACS) is an important sequalae of COVID-19. Then, our objective was to analyze the risk and protective factors for PACS in Brazilian adults participating in the Cohort of Universities of Minas Gerais (CUME Study), with emphasis on COVID-19 vaccination and food consumption.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In this sub-study, we included 2,065 participants of CUME Study who answered the baseline questionnaire in 2016 or 2018 or 2020 or 2022, and the follow-up COVID-19/PACS-specific questionnaire in 2023. PACS diagnosis was based on self-reporting of continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. To estimate the risk and protective factors for PACS, hierarchical multivariate statistical analysis was conducted using the Cox regression technique, producing two models: (1) focusing on consumption of macro and micronutrients; (2) focusing on consumption of food groups.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>After a median of 5.5 years of follow-up, 54.4% of the participants reported PACS. When we analyzed the consumption of macro and micronutrients, higher intake of proteins (HR: 1.36; 95% CI: 1.06–1.74-4th quartile) and lipids (HR: 1.23; 95% CI: 1.02–1.48-4th quartile) were risk factors for PACS. On the other hand, higher intake of vitamin C (HR: 0.78; 95% CI: 0.64–0.94-4th quartile), vitamin D (HR: 0.81; 95% CI: 0.67–0.99-4th quartile), and zinc (HR: 0.66; 95% CI: 0.52–0.83-4th quartile) were protective factors for the outcome (model 1). When we analyzed the consumption of food groups, higher intake of eggs (HR: 1.59; 95% CI: 1.34–1.89-4th quartile) increased the risk of PACS, whereas, respectively, higher and intermediate consumption of white meat (HR: 0.84; 95% CI: 0.71–1.00-4th quartile) and vegetables (HR: 0.81; 95% CI: 0.67–0.99-2nd quartile; HR: 0.81; 95% CI: 0.67–0.99-3rd quartile) decreased the risk of the outcome (model 2). In both models, pre-infection COVID-19 vaccination was a protective factor for PACS.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>A healthy diet, with higher consumption of white meat, vegetables and specific micronutrients (vitamin C, vitamin D, zinc), in parallel with pre-infection COVID-19 vaccination, is essential to reduce the risk of PACS.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fnut.2025.1549747" ], "author": [ { "affiliation": [], "family": "Brandão", "given": "Marlise Lima", "sequence": "first" }, { "affiliation": [], "family": "Hermsdorff", "given": "Helen Hermana Miranda", "sequence": "additional" }, { "affiliation": [], "family": "Leal", "given": "Arieta Carla Gualandi", "sequence": "additional" }, { "affiliation": [], "family": "Bressan", "given": "Josefina", "sequence": "additional" }, { "affiliation": [], "family": "Pimenta", "given": "Adriano Marçal", "sequence": "additional" } ], "container-title": "Frontiers in Nutrition", "container-title-short": "Front. Nutr.", "content-domain": { "crossmark-restriction": true, "domain": [ "frontiersin.org" ] }, "created": { "date-parts": [ [ 2025, 3, 14 ] ], "date-time": "2025-03-14T08:45:43Z", "timestamp": 1741941943000 }, "deposited": { "date-parts": [ [ 2025, 3, 14 ] ], "date-time": "2025-03-14T08:45:50Z", "timestamp": 1741941950000 }, "indexed": { "date-parts": [ [ 2025, 3, 15 ] ], "date-time": "2025-03-15T04:14:16Z", "timestamp": 1742012056020, "version": "3.38.0" }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2025, 3, 14 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2025, 3, 14 ] ], "date-time": "2025-03-14T00:00:00Z", "timestamp": 1741910400000 } } ], "link": [ { "URL": "https://www.frontiersin.org/articles/10.3389/fnut.2025.1549747/full", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1965", 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