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The pathophysiological mechanisms linking this persistence to post-COVID IBS likely involve: Sustained inflammatory responses with elevated interferon levels Expansion of activated immune cells even 8 months post-infection Intestinal dysbiosis affecting the gut-brain axis Increased intestinal permeability during and after infection These findings suggest that long-term GI symptoms after COVID-19 may stem from ongoing intestinal inflammation driven by viral persistence, rather than merely representing psychological sequelae of the acute illness

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Factor Xa Factor Xa is a serine protease that specifically cleaves a sequence I(E/D) GRX, where X can be any amino acid except arginine or proline, enabling removal of N-terminal affinity tags with minimal residual amino acids at the target proteins N-terminus [139]

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