Hull York Medical School, Hull, UK.
Department of Health Sciences, University of York, York, UK.
Immun Inflamm Dis. 2023 Oct;11(10):e1052. doi: 10.1002/iid3.1052.
Long-COVID is a heterogeneous condition with a litany of physical and neuropsychiatric presentations and its pathophysiology remains unclear. Little is known about the association between inflammatory biomarkers, such as interleukin-6 (IL-6) and C-reactive protein (CRP) in the acute phase, and persistent symptoms after hospitalization in COVID-19 patients.
IL-6, CRP, troponin-T, and ferritin were analyzed at admission for all patients with COVID-19 between September 1, 2020 to January 10, 2021. Survivors were followed up 3-months following hospital discharge and were asked to report persistent symptoms they experienced. Admission data were retrospectively collected. Independent t-tests and Mann-Whitney U tests were performed.
In a sample of 144 patients (62.5% male, mean Age 62 years [SD = 13.6]) followed up 3 months after hospital discharge, the commonest symptoms reported were fatigue (54.2%), breathlessness (52.8%), and sleep disturbance (37.5%). In this sample, admission levels of IL-6, CRP and ferritin were elevated. However, those reporting myalgia, low mood, and anxiety at follow-up had lower admission levels of IL-6 (34.9 vs. 52.0 pg/mL, p = .043), CRP (83 vs. 105 mg/L, p = .048), and ferritin (357 vs. 568 ug/L, p = .01) respectively, compared with those who did not report these symptoms. Multivariate regression analysis showed that these associations were confounded by gender, as female patients had significantly lower levels of IL-6 and ferritin on admission (29.5 vs. 56.1, p = .03 and 421.5 vs. 589, p = .001, respectively) and were more likely to report myalgia, low mood and anxiety, when compared to males.
Our data demonstrate that female patients present more often with lower levels of inflammatory biomarkers on admission which are subsequently associated with long-term post-COVID symptoms, such as myalgia and anxiety, in those discharged from hospital with severe COVID-19. Further research is needed into the role of serum biomarkers in post-COVID prognostication.
长新冠是一种具有多种躯体和神经精神表现的异质性疾病，其病理生理学仍不清楚。人们对炎症生物标志物（如白细胞介素 6（IL-6）和 C 反应蛋白（CRP））在急性期中的作用以及 COVID-19 患者住院后持续存在的症状知之甚少。
2020 年 9 月 1 日至 2021 年 1 月 10 日期间，对所有 COVID-19 患者入院时均分析了 IL-6、CRP、肌钙蛋白 T 和铁蛋白。幸存者在出院后 3 个月进行随访，并被要求报告他们经历的持续症状。回顾性收集入院数据。进行了独立 t 检验和曼-惠特尼 U 检验。
在 144 例（62.5%为男性，平均年龄 62 岁[SD=13.6]）患者中，他们在出院后 3 个月接受了随访，报告的最常见症状是疲劳（54.2%）、呼吸困难（52.8%）和睡眠障碍（37.5%）。在该样本中，入院时的 IL-6、CRP 和铁蛋白水平升高。然而，在随访时报告有肌痛、情绪低落和焦虑的患者入院时的 IL-6（34.9 与 52.0pg/mL，p=0.043）、CRP（83 与 105mg/L，p=0.048）和铁蛋白（357 与 568μg/L，p=0.01）水平较低。多变量回归分析表明，这些关联受到性别混杂的影响，因为女性患者入院时的 IL-6 和铁蛋白水平显著降低（分别为 29.5 与 56.1，p=0.03 和 421.5 与 589，p=0.001），并且与男性相比，更有可能报告肌痛、情绪低落和焦虑。
我们的数据表明，女性患者入院时炎症生物标志物水平较低，随后与 COVID-19 出院后长期出现的症状（如肌痛和焦虑）相关，而男性患者入院时炎症生物标志物水平较低。需要进一步研究血清生物标志物在 COVID-19 预后中的作用。
