Endocrine and Metabolic Characteristics and Prognosis of Long COVID Following SARS-CoV-2 Infection During the Omicron Period
- 1Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
Abstract
Background: The clinical features and recovery of patients with obesity and Long COVID remain incompletely understood. Methods: We retrospectively analyzed 903 patients attending a COVID-19 aftercare clinic during the Omicron period. Biomarkers were compared across body mass index (BMI) categories. Recovery was defined as physician-determined conclusion of outpatient follow-up following sufficient symptom improvement, not necessarily complete resolution. Recovery analyses were exploratory; 572 patients comprised a sensitivity cohort clinically compatible with the World Health Organization (WHO) post-COVID-19 condition definition. Results: Serum ferritin levels were higher in overweight and obese men than in normal-weight men. Cortisol/adrenocorticotropic hormone (ACTH) ratios in women and free thyroxine (FT4) levels in men differed across BMI categories. Recovery analysis from symptom onset included 565 participants and 186 events. Men with obesity had a lower recovery hazard than normal-weight men, with consistent direction across sensitivity analyses (age-adjusted pooled model, n = 565; hazard ratio: 0.390; 95% CI: 0.170–0.894), based on six recovery events among men with obesity. The main sex-by-obesity interaction was nonsignificant; additional interaction results varied by model. The WHO-compatible recovery analysis was limited by sparse events. Conclusions: Obesity was associated with a longer time to clinically defined recovery among men, alongside BMI-related endocrine–metabolic differences. These exploratory findings warrant confirmation; sparse events and residual confounding preclude causal or definitive sex-specific conclusions.
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BibTeX
@article{omura2026endocrine,
title = {{Endocrine and Metabolic Characteristics and Prognosis of Long COVID Following SARS-CoV-2 Infection During the Omicron Period}},
author = {Daisuke Omura and Yoshiaki Soejima and Yuki Otsuka and Yasuhiro Nakano and Kazuki Tokumasu and Yui Matsuda and Yasue Sakurada and Ryosuke Takase and Atsuhito Suyama and Marina Kawaguchi and Toru Hasegawa and Hiroyuki Honda and Keigo Ueda and Fumio Otsuka},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218492},
url = {https://www.mdpi.com/2077-0383/15/21/8492},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Endocrine and Metabolic Characteristics and Prognosis of Long COVID Following SARS-CoV-2 Infection During the Omicron Period
AU - Daisuke Omura
AU - Yoshiaki Soejima
AU - Yuki Otsuka
AU - Yasuhiro Nakano
AU - Kazuki Tokumasu
AU - Yui Matsuda
AU - Yasue Sakurada
AU - Ryosuke Takase
AU - Atsuhito Suyama
AU - Marina Kawaguchi
AU - Toru Hasegawa
AU - Hiroyuki Honda
AU - Keigo Ueda
AU - Fumio Otsuka
PY - 2026
DA - 2026/11/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218492
UR - https://www.mdpi.com/2077-0383/15/21/8492
AB - Background: The clinical features and recovery of patients with obesity and Long COVID remain incompletely understood. Methods: We retrospectively analyzed 903 patients attending a COVID-19 aftercare clinic during the Omicron period. Biomarkers were compared across body mass index (BMI) categories. Recovery was defined as physician-determined conclusion of outpatient follow-up following sufficient symptom improvement, not necessarily complete resolution. Recovery analyses were exploratory; 572 patients comprised a sensitivity cohort clinically compatible with the World Health Organization (WHO) post-COVID-19 condition definition. Results: Serum ferritin levels were higher in overweight and obese men than in normal-weight men. Cortisol/adrenocorticotropic hormone (ACTH) ratios in women and free thyroxine (FT4) levels in men differed across BMI categories. Recovery analysis from symptom onset included 565 participants and 186 events. Men with obesity had a lower recovery hazard than normal-weight men, with consistent direction across sensitivity analyses (age-adjusted pooled model, n = 565; hazard ratio: 0.390; 95% CI: 0.170–0.894), based on six recovery events among men with obesity. The main sex-by-obesity interaction was nonsignificant; additional interaction results varied by model. The WHO-compatible recovery analysis was limited by sparse events. Conclusions: Obesity was associated with a longer time to clinically defined recovery among men, alongside BMI-related endocrine–metabolic differences. These exploratory findings warrant confirmation; sparse events and residual confounding preclude causal or definitive sex-specific conclusions.
SN - 2077-0383
ER -