Page 120 - MI-2-2

Microbes & Immunity Physiological and cognitive effects of PASC

decreased from 0.319 for the no-booster group to 0.16 3 for mental strain affecting patients’ behavior and mental
the three-booster group, while duration scores decreased health. The loading score of 1.0 for behavior indicates a
from 0.714 to 0.444, respectively, suggesting a downward strong correlation with the overall factor, suggesting that
trend with increasing boosters. PASC patients experience severe behavior disruptions.
The majority of participants (67.3%) were infected with Factor 3, identified as sensory dysfunction, comprised
COVID-19 after receiving at least a second vaccine dose of dysgeusia (loading=0.8), anosmia (loading=0.7), and
(Table 4). Of the remaining 32.7%, 1.8% were infected cranial nerve dysfunction (loading=0.4). As all these
after their single-dose vaccine. Males were more likely to symptoms are sensory nerve-related conditions, the high
become infected before completing their first complete loading values for dysgeusia and anosmia, as well as their
course of vaccination (two doses for double-dose vaccine, high correlation value, indicate their strong association.
one dose for single-dose vaccine), with 35% of males being Factor 4 was categorized as depression, encompassing
infected before a full vaccination compared to 29% of depression (loading=0.9) and suicidal thoughts
females. However, the variability in vaccination efficacy (loading=0.4), both of which also exhibited a high
between genders may be due to sampling variability. The correlation in early analysis. The dominant loading for
lower infection rate after the second booster compared to depression emphasizes the significant mental health
other categories is likely due to a lower rate of vaccination implications of PACS, suggesting that affected patients
for the second booster (45.5%) and the timing of the would benefit from comprehensive neuropsychiatric
second booster release. evaluation and support.
EFA identified four factors for symptom severity: For symptom duration, EFA similarly identified four
Respiratory and fatigue symptoms (e.g., cough factors: Psychological and cognitive (e.g., stress and
and breathlessness), psychological and behavioral working memory), respiratory and fatigue (e.g., cough and
disturbance (e.g., brain fog and stress), sensory sleep), sensory dysfunction (e.g., dysgeusia and anosmia),
dysfunction (e.g., dysgeusia and anosmia), and depression and depression (e.g., depression and suicidal thoughts)
(e.g., depression and suicidal thoughts) (Figure 5). We (Figure 6). These categories, for the most part, aligned with
classified Factor 1 as respiratory and fatigue symptoms, the factors constructed for symptom severity, reinforcing
including symptoms such as cough (loading=0.9), the strong correlation between symptom severity and
sleep disturbances (loading=0.7), throat sensitivity duration. We classified Factor 1 as psychological and
(loading=0.6), fatigue (loading=0.5), and breathlessness cognitive strain, characterized by symptoms including
(loading=0.4). This cluster reflects symptoms associated behavioral severity (loading=0.9), stress (loading=0.8), and
with both respiratory and fatigue-related problems. The working memory (loading=0.6). This grouping contrasts
high loading value of cough indicates that it is a key with the duration analysis, which categorized behavioral
symptom within this factor, consistent with the known and psychological symptoms separately from cognitive
respiratory effects of PASC. These findings suggest that impairments (Figure 5). The severity analysis indicates
patients in this cluster disproportionately suffer from that elevated stress and behavioral disruptions are closely
breathing difficulties and energy level impairments. linked to cognitive strain, suggesting that mental health
Factor 2 revealed the psychological impact of PASC challenges may worsen cognitive symptoms in patients
through psychological and behavioral disturbance, with PACS.
characterized by behavior (loading=1.0) and stress Factor 2, identified as respiratory and fatigue
(loading=0.8). This factor demonstrates the significant severity, includes cough (loading=0.8), throat sensitivity

Table 4. The distribution of participants’ infection timing relative to vaccination status
Vaccination status Number Male Female Prefer not to Number Male Female Prefer not to
of people infected infected say infected of people infected infected say infected
infected infected (%) (%) (%) (%)
Before vaccination 24 11 13 0 21.80 27.50 18.80 0
After 1 dose 12 4 8 0 10.90 10.00 11.60 0
st
After 2 dose 33 13 20 0 30.00 32.50 29.00 0
nd
After 1 booster shot 30 7 22 1 27.30 17.50 31.90 100.00
st
nd
After 2 booster shot 7 2 5 0 6.40 5.00 7.20 0
After 3 booster shot 4 3 1 0 3.60 7.50 1.40 0
rd
Volume 2 Issue 2 (2025) 112 doi: 10.36922/mi.8545