2026/03/01 by Tanja Kraus, Hendrik Napierala, Anne Schrimpf +223 · 1 citation
Medicine · #Long-Term Effects of COVID-19 #SARS-CoV-2 and COVID-19 Research #Peripheral Neuropathies and Disorders
paper · doi:10.1016/j.mayocp.2026.02.018
OBJECTIVE: To assess the impact of COVID-19 vaccination on distinct clinical definitions and phenotypes of post-COVID syndrome (PCS) and to identify risk factors for PCS despite vaccination. METHODS: Data were drawn from the German National Pandemic Cohort Network (NAPKON), including adult COVID-19 patients with known vaccination status recruited between December 2, 2020, and February 13, 2023. The prevalence of PCS was assessed by 3 clinical definitions: the broad World Health Organization definition (any sequelae at 3 months), symptom clusters (fatigue, respiratory, cognitive), and a symptom-based PCS score reflecting clinical severity. Multivariable logistic regression was employed to estimate the protective effect of vaccination. RESULTS: Of 756 patients, 26% were fully vaccinated (≥2 doses) before infection. Vaccination was associated with a significantly reduced risk of PCS according to the World Health Organization definition (odds ratio [OR], 0.555; 95% CI, 0.339 to 0.906), the PCS score (OR, 0.536; 95% CI, 0.335 to 0.856), the respiratory cluster (OR, 0.508; 95% CI, 0.295 to 0.875), and the cognitive cluster (OR, 0.443; 95% CI, 0.213 to 0.923). In contrast, no protective association was observed for the fatigue cluster (OR, 0.917; 95% CI, 0.554 to 1.519). The favorable association with vaccination was particularly observed in patients with mild acute symptoms, regardless of hospitalization. The protective effect of vaccination persisted at 12-month follow-up, although fatigue remained unaffected. CONCLUSION: Findings indicate that broader PCS definitions may mask clinically relevant heterogeneity and support the need for differentiated, phenotype-oriented definitions that reflect clinical presentations of PCS, including differential responses to vaccination. Such refined clinical definitions may facilitate exploration of whether these phenotypes reflect distinct underlying pathophysiologic mechanisms. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04768998.