Mathé Philipp, Götz Veronika, Stete Katarina, Walzer Dietrich, Hilger Hanna, Pfau Stefanie, Hofmann Maike, Rieg Siegbert, Kern Winfried V
Department of Medicine II, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Infection. 2025 Feb;53(1):463-466. doi: 10.1007/s15010-024-02397-5. Epub 2024 Oct 2.
Approximately 10-20% of patients previously infected with SARS-CoV-2 experience post-acute sequelae of COVID-19 (PASC), presenting with fatigue and neurocognitive dysfunction along various other symptoms. Recent studies suggested a possible role of a virally induced decrease in peripheral serotonin concentration in the pathogenesis of PASC. We set out to verify this finding in an independent and well-defined cohort of PASC patients from our post-COVID-19 outpatient clinic.
We performed a retrospective case-control study including 34 confirmed PASC patients and 14 healthy controls. Clinical assessment encompassed physician examination as well as questionnaire based evaluation. Eligibility required ongoing symptoms for at least 6 months post-PCR-confirmed infection, relevant fatigue (CFS ≥ 4), and no other medical conditions. Serum serotonin was determined by LC-MS/MS technique.
Serum serotonin levels in PASC patients did not significantly differ from healthy controls. Most subjects had normal serotonin levels, with no subnormal readings. Subgroup analyses showed no significant differences in serotonin levels based according to predominant fatigue type, high overall fatigue score or depression severity.
We postulate that peripheral serotonin is no reliable biomarker for PASC and that it should not be used in routine diagnostic. Therapy of PASC with serotonin-reuptake inhibitors or tryptophane supplementation should not be based solely on the assumption of lowered serotonin levels.
约10%-20%曾感染过严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者会出现新冠病毒感染后急性后遗症（PASC），表现为疲劳和神经认知功能障碍以及其他各种症状。最近的研究表明，病毒诱导外周血清素浓度降低在PASC发病机制中可能起作用。我们着手在我们新冠后门诊诊所的一组独立且明确界定的PASC患者队列中验证这一发现。
我们进行了一项回顾性病例对照研究，纳入34例确诊的PASC患者和14名健康对照。临床评估包括医生检查以及基于问卷的评估。入选要求在PCR确诊感染后至少持续出现症状6个月、有相关疲劳（慢性疲劳综合征评分≥4）且无其他疾病。血清血清素通过液相色谱-串联质谱（LC-MS/MS）技术测定。
PASC患者的血清血清素水平与健康对照无显著差异。大多数受试者血清素水平正常，无低于正常的读数。亚组分析显示，根据主要疲劳类型、高总体疲劳评分或抑郁严重程度，血清素水平无显著差异。
我们推测外周血清素不是PASC的可靠生物标志物，不应将其用于常规诊断。使用血清素再摄取抑制剂或补充色氨酸治疗PASC不应仅基于血清素水平降低的假设。
