Stereo audio output lost after Dr46onized update on Lenovo Thinkpad (usually running hardened)

To me it looks like your pipewire is not installed correctly as in pipewire-alsa is definitely missing here but that might not be the only thing wrong here. Try to reinstall pipewire following this post.

Also, I would recommend removing sndio having two sound servers might be one of the reasons why you suddenly have no sound. Infact try removing this first and then go for reinstalling pipewire.

sudo pacman -Rns sndio