Clinical and Proteomic Associations of SARS-CoV-2 Infection and COVID-19 Vaccination in Multimorbid Patients: A Cross-Sectional Observational Study

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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COVID Infection and Vaccination Trigger Long-Term Changes in Older, Sicker Adults, But More Research Is Needed

In a cross-sectional study of multimorbid older adults, both SARS-CoV-2 infection and vaccination, particularly with mRNA vaccines, were associated with distinct, long-lasting systemic alterations, including inflammation, coagulation changes, and potential organ stress. These changes were observed more than six months post-vaccination and highlight the need for further research into long-term effects, especially in vulnerable populations.

Possible Conflicts of Interest

Authors A.H. and T.L. were employed by Pharmacoidea Ltd. No other conflicts were disclosed.

Identified Weaknesses

Cross-sectional observational study design

Limits the ability to draw causal relationships between variables.

Single-center study

Difficult to generalize findings to other populations.

Small sample size for specific subgroups

The small sample size, especially in the COV- vac- group, weakens the statistical power.

Limited treatment and medication information

Lack of detailed treatment data and potential variations in medication use across groups.

No pre-infection/pre-vaccination baseline data

Unclear whether the observed biomarker differences were present before infection or vaccination due to cross-sectional design.

Rating Explanation

This is an average study with several limitations, chiefly its cross-sectional design and limited sample size in key subgroups. While the integrated clinical and proteomic approach is valuable, the inability to establish causality or generalize findings weakens the overall impact.

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