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. 2025 Mar 14:12:1549747.
doi: 10.3389/fnut.2025.1549747. eCollection 2025.

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

Marlise Lima Brandão #  1 , Helen Hermana Miranda Hermsdorff  2 , Arieta Carla Gualandi Leal  2 , Josefina Bressan  2 , Adriano Marçal Pimenta #  3
Affiliations

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

Marlise Lima Brandão et al. Front Nutr. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: COVID-19; Post-Acute COVID-19 Syndrome; cohort studies; eating; vaccination.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of participant inclusion in the CUME Study, 2016–2023.
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