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Microbes & Immunity Physiological and cognitive effects of PASC

representation may lead to more accurate predictions and severity scores across symptoms, such as stress, sleep
analyses of symptoms for females. It is important to note disturbances, and depressive symptoms. This finding
that focusing on a demographic with lower susceptibility to highlights the importance of vaccination in mitigating the
the disease could underestimate its broader impact. Thus, long-term effects of COVID-19, although the presence of
expanding the sample to include a larger, more diverse breakthrough infections highlights the need for continued
group would provide a more comprehensive understanding. surveillance and tailored interventions.
5. Conclusion Overall, this study contributes to the growing literature
on COVID-19 by identifying demographic disparities and
This study aimed to investigate the prevalence, severity, emphasizing the complex and multifactorial natures of
and demographic influences on symptoms associated with PACS. However, limitations, such as the overrepresentation
PASC. The EFA identified four primary symptom clusters of female and Asian-American participants and reliance
for PACS, both for the symptom severity and duration: on self-reported data, suggest caution when generalizing
(i) respiratory and fatigue symptoms (e.g., cough, fatigue, the findings to the broader population. Future research
and breathlessness), including significant respiratory should utilize a larger, more diverse sample and explore
impacts; (ii) psychological and behavioral disturbance (e.g., the influence of SARS-CoV-2 variants and socioeconomic
stress and behavioral changes), which highlighted the mental factors on symptom severity and duration. The findings
strain of PACS; (iii) sensory dysfunction (e.g., dysgeusia of this study could guide public health strategies and
and anosmia), indicating that neurological impacts on underscore the importance of tailored interventions for
sensory pathways are still prevalent post-infection; and PACS based on demographic factors and symptom severity.
(iv) depression (e.g., depression and suicidal ideation),
which highlighted neuropsychiatric effects. These findings Acknowledgments
demonstrate the multifaceted impact of PACS and highlight The authors would like to express their gratitude to
the need for multidisciplinary management strategies the Aspiring Scholars Directed Research Program for
addressing physical, psychological, and neurological health. providing the support that made this study possible. In

The findings indicate that sleep disturbances were the addition, the authors are grateful to the participants who
most prevalent symptom, with a mean severity score of participated in this study and made it possible.
1.15 and duration of 2 – 4 weeks. These conclusions align
with previous studies, which highlight sleep disruptions Funding
as a common long-term consequence of COVID-19. On None.
6
the other hand, suicidal thoughts were the least reported
symptom, with a mean severity of 0.06, suggesting that Conflict of interest
they are less commonly associated with PACS in the
studied population. The authors declare that they have no competing interests.
Demographic factors played a significant role in the Author contributions
severity of the symptoms experienced. Female participants Conceptualization: Sahar Jahanikia
consistently reported higher severity scores for both Data curation: All authors
physiological and cognitive symptoms compared to males, Formal analysis: Rohan Melwani, Keerthana Noru, Sanya
corroborating findings that women tend to experience more Kondapalli, Ameya Ravi, Saanvi Shah, Shreeya Setty,
severe post-infection symptoms. Possible explanations Sahar Jahanikia
41
include immune system differences, as women generally Funding acquisition: Sahar Jahanikia
have stronger immune responses, which may lead to Investigation: Rohan Melwani, Keerthana Noru, Sanya
increased inflammation post-infection, contributing to Kondapalli, Ameya Ravi, Saanvi Shah, Shreeya Setty,
prolonged symptoms. Hormonal factors also play a role, Sahar Jahanikia
as estrogen and progesterone influence immune responses Methodology: Rohan Melwani, Keerthana Noru, Sanya
and may affect symptom persistence. Meanwhile, age also Kondapalli, Shreeya Setty, Sahar Jahanikia
influenced symptom reporting, with adults aged 35 – 49 Project administration: Sahar Jahanikia
demonstrating a higher likelihood of experiencing PACS. Supervision: Sahar Jahanikia
This trend may reflect age-related immune responses or Visualization: Rohan Melwani, Keerthana Noru, Ameya
occupational exposure risks. Ravi, Saanvi Shah, Shreeya Setty
As hypothesized, vaccination was a significant Writing – original draft: Rohan Melwani, Keerthana Noru,
variable, with vaccinated participants reporting lower Sanya Kondapalli, Ameya Ravi, Saanvi Shah, Shreeya

Volume 2 Issue 2 (2025) 115 doi: 10.36922/mi.8545