Laboratory findings and biomarkers in Long COVID: What do we know so far? Insights into epidemiology, pathogenesis, therapeutic perspectives and challenges
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Laboratory findings and biomarkers in Long COVID: What do we know so far? Insights into epidemiology, pathogenesis, therapeutic perspectives and challenges. / Tsilingiris, Dimitrios; Vallianou, Natalia G; Karampela, Irene; Christodoulatos, Gerasimos Socrates; Papavasileiou, Georgios; Petropoulou, Dimitra; Magkos, Faidon; Dalamaga, Maria.
In: International Journal of Molecular Sciences, Vol. 24, No. 13, 10458, 2023.Research output: Contribution to journal › Review › Research › peer-review
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T1 - Laboratory findings and biomarkers in Long COVID: What do we know so far? Insights into epidemiology, pathogenesis, therapeutic perspectives and challenges
AU - Tsilingiris, Dimitrios
AU - Vallianou, Natalia G
AU - Karampela, Irene
AU - Christodoulatos, Gerasimos Socrates
AU - Papavasileiou, Georgios
AU - Petropoulou, Dimitra
AU - Magkos, Faidon
AU - Dalamaga, Maria
N1 - CURIS 2023 NEXS 167
PY - 2023
Y1 - 2023
N2 - Long COVID (LC) encompasses a constellation of long-term symptoms experienced by at least 10% of people after the initial SARS-CoV-2 infection, and so far it has affected about 65 million people. The etiology of LC remains unclear; however, many pathophysiological pathways may be involved, including viral persistence; a chronic, low-grade inflammatory response; immune dysregulation and a defective immune response; the reactivation of latent viruses; autoimmunity; persistent endothelial dysfunction and coagulopathy; gut dysbiosis; hormonal and metabolic dysregulation; mitochondrial dysfunction; and autonomic nervous system dysfunction. There are no specific tests for the diagnosis of LC, and clinical features including laboratory findings and biomarkers may not specifically relate to LC. Therefore, it is of paramount importance to develop and validate biomarkers that can be employed for the prediction, diagnosis and prognosis of LC and its therapeutic response, although this effort may be hampered by challenges pertaining to the non-specific nature of the majority of clinical manifestations in the LC spectrum, small sample sizes of relevant studies and other methodological issues. Promising candidate biomarkers that are found in some patients are markers of systemic inflammation, including acute phase proteins, cytokines and chemokines; biomarkers reflecting SARS-CoV-2 persistence, the reactivation of herpesviruses and immune dysregulation; biomarkers of endotheliopathy, coagulation and fibrinolysis; microbiota alterations; diverse proteins and metabolites; hormonal and metabolic biomarkers; and cerebrospinal fluid biomarkers. At present, there are only two reviews summarizing relevant biomarkers; however, they do not cover the entire umbrella of current biomarkers, their link to etiopathogenetic mechanisms or the diagnostic work-up in a comprehensive manner. Herein, we aim to appraise and synopsize the available evidence on the typical laboratory manifestations and candidate biomarkers of LC, their classification based on pathogenetic mechanisms and the main LC symptomatology in the frame of the epidemiological and clinical aspects of the syndrome and furthermore assess limitations and challenges as well as potential implications in candidate therapeutic interventions.
AB - Long COVID (LC) encompasses a constellation of long-term symptoms experienced by at least 10% of people after the initial SARS-CoV-2 infection, and so far it has affected about 65 million people. The etiology of LC remains unclear; however, many pathophysiological pathways may be involved, including viral persistence; a chronic, low-grade inflammatory response; immune dysregulation and a defective immune response; the reactivation of latent viruses; autoimmunity; persistent endothelial dysfunction and coagulopathy; gut dysbiosis; hormonal and metabolic dysregulation; mitochondrial dysfunction; and autonomic nervous system dysfunction. There are no specific tests for the diagnosis of LC, and clinical features including laboratory findings and biomarkers may not specifically relate to LC. Therefore, it is of paramount importance to develop and validate biomarkers that can be employed for the prediction, diagnosis and prognosis of LC and its therapeutic response, although this effort may be hampered by challenges pertaining to the non-specific nature of the majority of clinical manifestations in the LC spectrum, small sample sizes of relevant studies and other methodological issues. Promising candidate biomarkers that are found in some patients are markers of systemic inflammation, including acute phase proteins, cytokines and chemokines; biomarkers reflecting SARS-CoV-2 persistence, the reactivation of herpesviruses and immune dysregulation; biomarkers of endotheliopathy, coagulation and fibrinolysis; microbiota alterations; diverse proteins and metabolites; hormonal and metabolic biomarkers; and cerebrospinal fluid biomarkers. At present, there are only two reviews summarizing relevant biomarkers; however, they do not cover the entire umbrella of current biomarkers, their link to etiopathogenetic mechanisms or the diagnostic work-up in a comprehensive manner. Herein, we aim to appraise and synopsize the available evidence on the typical laboratory manifestations and candidate biomarkers of LC, their classification based on pathogenetic mechanisms and the main LC symptomatology in the frame of the epidemiological and clinical aspects of the syndrome and furthermore assess limitations and challenges as well as potential implications in candidate therapeutic interventions.
KW - Biomarkers
KW - COVID-19
KW - Epidemiology
KW - Laboratory
KW - Long COVID
KW - Pathogenesis
KW - Post-acute sequelae of SARS-CoV infection (PASC)
KW - Post-COVID
KW - Post-COVID syndrome (PCS)
KW - Humans
KW - Acute-Phase Proteins
KW - Inflammation
U2 - 10.3390/ijms241310458
DO - 10.3390/ijms241310458
M3 - Review
C2 - 37445634
VL - 24
JO - International Journal of Molecular Sciences (CD-ROM)
JF - International Journal of Molecular Sciences (CD-ROM)
SN - 1424-6783
IS - 13
M1 - 10458
ER -
ID: 360971306