The post-acute sequelae of COVID-19 (PASC) poses a significant health challenge in the post-pandemic world. However, the underlying biological mechanisms of PASC remain intricate and elusive. Network-based methods can leverage electronic health record data and biological knowledge to investigate the impact of COVID-19 on PASC and uncover the underlying biological mechanisms. This study analyzed territory-wide longitudinal electronic health records (from January 1, 2020 to August 31, 2022) of 50 296 COVID-19 patients and a healthy non-exposed group of 100 592 individuals to determine the impact of COVID-19 on disease progression, provide molecular insights, and identify associated biomarkers. We constructed a comorbidity network and performed disease-protein mapping and protein–protein interaction network analysis to reveal the impact of COVID-19 on disease trajectories. Results showed disparities in prevalent disease comorbidity patterns, with certain patterns exhibiting a more pronounced influence by COVID-19. Overlapping proteins elucidate the biological mechanisms of COVID-19's impact on each comorbidity pattern, and essential proteins can be identified based on their weights. Our findings can help clarify the biological mechanisms of COVID-19, discover intervention methods, and decode the molecular basis of comorbidity associations, while also yielding potential biomarkers and corresponding treatments for specific disease progression patterns.
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February 2025
Research Article|
February 20 2025
Deciphering the molecular mechanism of post-acute sequelae of COVID-19 through comorbidity network analysis

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Lue Tian
;
Lue Tian
(Conceptualization, Formal analysis, Investigation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing)
1
School of Data Science, City University of Hong Kong
, Hong Kong, China
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Eric Wan;
Eric Wan
(Data curation, Funding acquisition, Investigation, Writing – review & editing)
2
Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
3
Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
4
Laboratory of Data Discovery for Health
, Hong Kong, China
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Sze Ling Celine Chui;
Sze Ling Celine Chui
(Data curation, Formal analysis, Funding acquisition, Investigation, Writing – review & editing)
4
Laboratory of Data Discovery for Health
, Hong Kong, China
5
School of Nursing, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
6
School of Public Health, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
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Shirely Li;
Shirely Li
(Data curation, Funding acquisition, Investigation, Writing – review & editing)
2
Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
4
Laboratory of Data Discovery for Health
, Hong Kong, China
7
Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
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Esther Chan
;
Esther Chan
(Data curation, Funding acquisition, Investigation)
2
Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
4
Laboratory of Data Discovery for Health
, Hong Kong, China
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Hao Luo;
Hao Luo
(Funding acquisition, Investigation, Writing – review & editing)
8
Department of Social Work and Social Administration, The University of Hong Kong
, Hong Kong, China
9
School of Public Health Sciences, The University of Waterloo
, Waterloo, Ontario N2L3G1, Canada
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Ian C. K. Wong;
Ian C. K. Wong
a)
(Data curation, Funding acquisition, Investigation, Project administration, Supervision)
1
School of Data Science, City University of Hong Kong
, Hong Kong, China
2
Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
4
Laboratory of Data Discovery for Health
, Hong Kong, China
10
School of Pharmacy, Aston University
, Birmingham B4 7ET, United Kingdom
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Qingpeng Zhang
Qingpeng Zhang
a)
(Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing)
1
School of Data Science, City University of Hong Kong
, Hong Kong, China
2
Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
4
Laboratory of Data Discovery for Health
, Hong Kong, China
Search for other works by this author on:
Lue Tian
1
Eric Wan
2,3,4
Sze Ling Celine Chui
4,5,6
Shirely Li
2,4,7
Esther Chan
2,4
Hao Luo
8,9
Ian C. K. Wong
1,2,4,10,a)
Qingpeng Zhang
1,2,4,a)
1
School of Data Science, City University of Hong Kong
, Hong Kong, China
2
Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
3
Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
4
Laboratory of Data Discovery for Health
, Hong Kong, China
5
School of Nursing, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
6
School of Public Health, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
7
Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong
, Hong Kong, China
8
Department of Social Work and Social Administration, The University of Hong Kong
, Hong Kong, China
9
School of Public Health Sciences, The University of Waterloo
, Waterloo, Ontario N2L3G1, Canada
10
School of Pharmacy, Aston University
, Birmingham B4 7ET, United Kingdom
Chaos 35, 021102 (2025)
Article history
Received:
November 28 2024
Accepted:
January 11 2025
Connected Content
A companion article has been published:
Mapping comorbidity patterns and associated proteins to help fight “long COVID”
Citation
Lue Tian, Eric Wan, Sze Ling Celine Chui, Shirely Li, Esther Chan, Hao Luo, Ian C. K. Wong, Qingpeng Zhang; Deciphering the molecular mechanism of post-acute sequelae of COVID-19 through comorbidity network analysis. Chaos 1 February 2025; 35 (2): 021102. https://doi.org/10.1063/5.0250923
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