Prevention of Organ Failure (PROOF) Centre of Excellence, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada; UBC Centre for Heart Lung Innovation, Providence Research, St Paul's Hospital, Vancouver, BC, Canada.
Prevention of Organ Failure (PROOF) Centre of Excellence, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada; UBC Centre for Heart Lung Innovation, Providence Research, St Paul's Hospital, Vancouver, BC, Canada; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
EBioMedicine. 2023 May;91:104552. doi: 10.1016/j.ebiom.2023.104552. Epub 2023 Apr 8.
Long-COVID (LC) encompasses diverse symptoms lasting months after the initial SARS-CoV-2 infection. Symptoms can be debilitating and affect the quality of life of individuals with LC and their families. Although the symptoms of LC are well described, the aetiology of LC remains unclear, and consequently, patients may be underdiagnosed. Identification of LC specific biomarkers is therefore paramount for the diagnosis and clinical management of the syndrome. This scoping review describes the molecular and cellular biomarkers that have been identified to date with potential use for diagnosis or prediction of LC.
This review was conducted using the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews. A search was executed in the MEDLINE and EMBASE databases, as well as in the grey literature for original studies, published until October 5th, 2022, reporting biomarkers identified in participants with LC symptoms (from all ages, ethnicities, and sex), with a previous infection of SARS-CoV-2. Non-English studies, cross-sectional studies, studies without a control group, and pre-prints were excluded. Two reviewers independently evaluated the studies, extracted population data and associated biomarkers.
23 cohort studies were identified, involving 2163 LC patients [median age 51.8 years, predominantly female sex (61.10%), white (75%), and non-vaccinated (99%)]. A total of 239 candidate biomarkers were identified, consisting mainly of immune cells, immunoglobulins, cytokines, and other plasma proteins. 19 of the 239 candidate biomarkers identified were evaluated by the authors, by means of receiver operating characteristic (ROC) curves.
Diverse cellular and molecular biomarkers for LC have been proposed. Validation of candidate biomarkers in independent samples should be prioritized. Modest reported performance (particularly in larger studies) suggests LC may encompass many distinct aetiologies, which should be explored e.g., by stratifying by symptom clusters and/or sex.
Dr. Tebbutt has received funding from the Canadian Institutes of Health Research (177747) to conduct this work. The funding source was not involved in this scoping review, or in the decision to submit this manuscript for publication.
长新冠（LC）包含在初始 SARS-CoV-2 感染后持续数月的多种症状。这些症状可能使人虚弱，并影响 LC 患者及其家人的生活质量。尽管 LC 的症状描述得很清楚，但 LC 的病因仍不清楚，因此患者可能被误诊。因此，确定 LC 特异性生物标志物对于该综合征的诊断和临床管理至关重要。本范围综述描述了迄今为止已确定的具有用于 LC 诊断或预测潜在用途的分子和细胞生物标志物。
本综述使用 Joanna Briggs 研究所（JBI）范围综述方法进行。在 MEDLINE 和 EMBASE 数据库以及灰色文献中进行了搜索，以获取截至 2022 年 10 月 5 日报告在有 LC 症状（来自所有年龄、种族和性别的患者）的参与者中确定的生物标志物的原始研究。排除非英文研究、横断面研究、无对照组的研究和预印本。两名审查员独立评估研究，提取人群数据和相关生物标志物。
确定了 23 项队列研究，涉及 2163 名 LC 患者[中位年龄 51.8 岁，主要为女性（61.10%）、白人（75%）和未接种疫苗（99%）]。共确定了 239 种候选生物标志物，主要由免疫细胞、免疫球蛋白、细胞因子和其他血浆蛋白组成。239 种候选生物标志物中有 19 种被作者通过接收者操作特征（ROC）曲线进行了评估。
已经提出了多种用于 LC 的细胞和分子生物标志物。应优先验证独立样本中的候选生物标志物。报告的性能较差（特别是在较大的研究中）表明 LC 可能包含许多不同的病因，应该通过分层分析症状群和/或性别等来探索这些病因。
Tebbutt 博士收到了加拿大卫生研究院（177747）的资助，用于开展这项工作。资金来源未参与这项范围综述，也未参与决定提交这份手稿供出版。
