Background. Long COVID has been associated with increased cardiovascular risk and chronic low-grade inflammation, raising concerns about its long-term metabolic consequences. Given that the Mediterranean diet (MD) has shown beneficial effects on cardiovascular risk factors and inflammation in various populations, it is important to explore its potential impact on individuals with Long COVID. Therefore, the aim is to determine the association of the MD with cardiovascular risk factors (CVRF) and metabolic syndrome (MetS) in Caucasian subjects diagnosed with Long COVID. Methods. Cross-sectional study, 305 subjects diagnosed with Long COVID were included following the WHO criteria. Adherence to MD was evaluated with the MEDAS (Mediterranean Diet Adherence Screener) with 14 items used in Prevention with Mediterranean Diet study (PREDIMED study). The criteria considered to diagnose MetS were blood pressure, glycemia, triglycerides, HDL cholesterol, and waist circumference. Other CVRFs considered were tobacco consumption, total cholesterol, LDL cholesterol, body mass index, and baseline uric acid levels. The association between MD with CVRF and the number and components of MetS was analyzed using multiple regression models and multinomial regression. Results. The mean age was 52.75 ± 11.94 years (men 55.74 ± 12.22 and women 51.33 ± 11.57; p = 0.002), (68% women). The mean of the MEDAS questionnaire was 7.76 ± 2.37. The presented MetS were 23.6% (39.8% men and 15.9% women p < 0.001). In the multiple regression analysis, after adjusting for age and average time from acute COVID-19 infection to the date of inclusion in this study, the mean MD score showed a negative association with uric acid (β = −0.295; 95% CI: −0.496 to −0.093), BMI (β = −0.049; 95% CI: −0.096 to −0.002), the number of MetS components (β = −0.210; 95% CI: −0.410 to −0.010), and waist circumference (WC) (β = −0.021; 95% CI: −0.037 to −0.003) and a positive association with HDL cholesterol (β = −0.018; 95% CI: 0.001 to −0.037). Conclusions. The findings of this study suggest that higher Mediterranean diet scores are associated with lower levels of uric acid, fewer MetS components, smaller waist circumference, and higher HDL cholesterol levels in individuals with Long COVID.

Background: The relationship between alcohol consumption and vascular structure and arterial stiffness is not clear, especially in people diagnosed with persistent COVID. The aim of this study was to evaluate how alcohol use is related to vascular structure and arterial stiffness in adults with persistent COVID. Methods: A descriptive cross-sectional study was conducted involving 305 individuals (97 men and 208 women) diagnosed with persistent COVID according to the WHO criteria. Arterial stiffness was assessed by measuring the cardio-ankle vascular index (CAVI) and the brachial-ankle pulse wave velocity (ba-PWV) with a VaSera VS-1500 device, and the carotid-femoral pulse wave velocity (cf-PWV) with a Sphygmocor device. Vascular structure was assessed by measuring carotid intima-media thickness (c-IMT) with a Sonosite Micromax ultrasound unit. Alcohol intake was calculated using a standardized questionnaire and quantified in g/week. Results: Mean alcohol intake was 29 ± 53 g/week (men 60 ± 76 g/w and women 15 ± 27 g/w; p < 0.001). Heavy drinkers showed higher levels of c-IMT, cf-PWV, ba-PWV and CAVI than non-drinkers (p < 0.05). The multinomial regression analysis adjusted for sex and lifestyles showed a positive association between heavy drinking and c-IMT and cf-PWV values (β = 1.08 (95% CI 1.01–1.17); β = 1.37 (95% CI 1.04–1.80); ba-PWV and CAVI figures showed a similar trend, without reaching statistical significance. Conclusions: The results of this study indicate that high alcohol use in patients with persistent COVID is linked to higher c-IMT and cf-PWV figures than in non-drinkers.

Background/Objectives: Long COVID (LC) is associated with more than 200 symptoms. This study aimed to evaluate the correlation between symptoms clusters and pharmacological treatment in patients with LC and to explore differences by sex. Methods: We conducted a cross-sectional descriptive study including 304 participants diagnosed with LC according to the World Health Organization criteria. Symptoms during the acute phase, at the time of diagnosis of LC, and those persisting across both phases were collected by anamnesis. Symptoms were grouped into six clusters: systemic, neurocognitive, respiratory/cardiovascular, musculoskeletal, neurological/neuromuscular, and psychological/psychiatric. Drug use was assessed through a questionnaire verified by the medical records, including the consumption of cardiovascular drugs, antidepressants/anxiolytics, and anti-inflammatory/analgesics. Results: Patients reported a mean of 5.23 ± 1.10 symptoms in the acute phase, 4.20 ± 1.70 at LC diagnosis, and 3.83 ± 1.80 persisting across both phases. The most consumed pharmacological group was cardiovascular drugs (43.3%), followed by antidepressants/anxiolytics (34.8%). Psychotropic drugs and anti-inflammatory/analgesic drugs showed a positive association with all symptomatic groups (p < 0.05). Cardiovascular drugs showed a positive association with cardiorespiratory (β = 0.19, p < 0.05), neuromuscular (β = 0.11, p < 0.05), and psychological (β = 0.14, p < 0.05) symptoms. Conclusions: Psychotropic and anti-inflammatory/analgesic drugs were positively associated with all symptom clusters, while cardiovascular drugs were associated only with cardiorespiratory, neuromuscular, and psychological symptoms, highlighting the relevance of better characterization of treatment patterns in this population.

Introduction: Persistent COVID-19 is associated with microvascular dysfunction, with retinal vessels as potential early biomarkers. Obesity, particularly visceral adiposity, contributes to this dysfunction; however, the body mass index (BMI) is limited in its ability to assess it. Therefore, more precise alternative anthropometric indices have been proposed, although their relationship with retinal vascular caliber in persistent COVID-19 has not been studied. Objective: To analyze the relationship between different anthropometric measurements and the caliber of retinal vessels in an adult population with persistent COVID-19. Materials and Methods: This was an observational, descriptive, and cross-sectional study and included individuals diagnosed with persistent COVID-19. Retinal images were obtained using a non-mydriatic retinograph. The anthropometric variables used included: waist and hip circumference, BMI, waist-to-height ratio (WHtR), Body Roundness Index (BRI), Abdominal Volume Index (AVI), and body composition parameters measured by bioelectrical impedance analysis. Results: The sample included 284 participants (mean age: 52.7 years; 31.8% men). Men exhibited greater general and abdominal adiposity. The AV Index was negatively associated with various anthropometric indicators (BMI, BRI, waist circumference, and AVI), while venular caliber showed positive associations with all these indices, except for BMI (p < 0.05 for all). No significant correlations were found between anthropometric values and arteriolar caliber. These associations persisted after adjusting for age, sex, and pharmacological treatment. Conclusions: Individuals with obesity are associated with alterations in retinal vessels in patients with persistent COVID-19, evidenced by an increase in venous caliber and a decrease in the AV Index. However, these findings should be interpreted cautiously.

Background: Long COVID (LC) has been associated with persistent inflammation and endothelial dysfunction. Dietary components, particularly vitamins, are involved in inflammation, oxidative stress, and vascular homeostasis, and may influence arterial stiffness in this population. However, the relationship between dietary vitamin intake and vascular stiffness parameters in patients with LC remains poorly understood. Objective: To analyze the association between dietary vitamin intake and central and peripheral arterial stiffness, evaluated by carotid–femoral pulse wave velocity (cfPWV) and brachial–ankle pulse wave velocity (baPWV), in patients with LC. Methods: We conducted a cross-sectional study that included 304 patients with LC. Dietary vitamin intake was assessed using a validated 7-day dietary record (EVIDENT tool). Vascular assessment included cfPWV and baPWV, measured using validated devices (SphygmoCor^® and VaSera^®). Multiple linear regression analyses were performed to evaluate the associations between vitamin intake and vascular parameters. Model 1 was adjusted for age and sex, while Model 2 additionally included the number of metabolic syndrome components, the SF-36 general health domain, and adherence to the Mediterranean diet. Correction for multiple comparisons was performed using the Benjamini–Hochberg procedure across 36 vitamin–outcome–model contrasts. Results: The mean age was 52.78 ± 11.91 years, and 207 participants were women (68.1%); men were older than women (p = 0.004). In multiple regression analysis, inverse estimates for vitamin B1 intake with cfPWV were observed in both Model 1 (β = −0.568; 95% CI: −1.016 to −0.119; p = 0.014) and Model 2 (β = −0.491; 95% CI: −0.923 to −0.059; p = 0.027). Vitamin B6 intake showed a similar pattern with cfPWV in Model 1 (β = −0.312; 95% CI: −0.606 to −0.018; p = 0.039) and Model 2 (β = −0.302; 95% CI: −0.586 to −0.018; p = 0.038). Vitamin B2 showed inverse but non-significant associations with cfPWV. No significant associations were observed between vitamin intake and baPWV. After FDR correction, no vitamin-arterial stiffness association remained statistically significant; the FDR-adjusted q-value for the B1/B6-cfPWV estimates was 0.347. Conclusions: In this exploratory cross-sectional study, habitual food-based vitamin intake was not significantly associated with central or peripheral arterial stiffness after correction for multiple comparisons. Vitamins B1 and B6 showed inverse nominal estimates with cfPWV; however, these estimates did not survive FDR correction and were not reproduced for baPWV. Longitudinal studies incorporating biochemical micronutrient markers, medication and supplementation data, inflammatory and homocysteine-related biomarkers, and repeated vascular assessment are needed to clarify whether vitamin status is related to vascular health among individuals with persistent post-COVID-19 symptoms.

Background/Objectives: Long COVID-19 (LC) has been associated with persistent inflammation and impaired vascular health. Dietary minerals are involved in oxidative stress, endothelial homeostasis, and arterial stiffness; however, their relationship with vascular health in LC remains poorly explored. This study aimed to examine the association between energy-adjusted dietary mineral intake and markers of vascular stiffness and vascular aging in adults with LC, while exploring potential sex-specific patterns. Methods: A total of 304 adults with LC from the BioICOPER study were included. Dietary mineral intake was assessed using a validated 7-day dietary record from the EVIDENT tool and expressed as mineral density per 1000 kcal for the regression analyses. Vascular assessment included carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), brachial-ankle pulse wave velocity (baPWV), and the vascular aging index (VAI). Hierarchical multivariable linear regression models, false discovery rate (FDR) correction, restricted cubic spline analyses, sensitivity analyses excluding supplement users, and formal sex × mineral interaction tests were performed. Results: In descriptive adequacy analyses, adequate iron intake was associated with lower baPWV. In energy-adjusted linear regression models, no mineral-outcome association remained statistically significant after FDR correction. In the fully adjusted sensitivity model, zinc density showed a nominal positive association with cfPWV, but this association did not survive FDR correction. Restricted cubic spline analyses suggested possible non-linear associations of magnesium and potassium density with cfPWV and VAI. Formal interaction analyses did not provide robust evidence of sex-related effect modification. Conclusions: After energy adjustment and correction for multiple testing, the evidence for independent linear associations between dietary mineral density and vascular outcomes in adults with LC was limited. These exploratory findings suggest that mineral intake, dietary sources, and non-linear patterns deserve further evaluation in prospective studies and nutritional intervention trials.