Gerber Lynn H, Estep Micahel, De Avila Leyla, Price Jillian K, Weinstein Ali A, Stepanova Maria, Birerdinc Aybike, Younossi Zobair
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
Department of Medicine, Inova Health System, Falls Church, VA, USA.
Int J Gen Med. 2025 Sep 2;18:4975-4985. doi: 10.2147/IJGM.S534539. eCollection 2025.
The diagnosis of post-acute SARS-CoV-2 infection (PASC) is broad, referring to new or persistent health problems >four weeks after being infected with SARSCoV-2. The aim of this study was to determine whether cytokines, chemokines or catecholamine levels could specify the clinical condition.
Seventy-nine participants participated in person to study PASC. They were average 51 years (mean), 52% female, 62% Caucasian, 11% African American and 37% Hispanic with a mean BMI of 30.5. Most prevalent symptoms were fatigue, memory loss and shortness of breath. We extracted co-morbid conditions, length of hospital stay and course and laboratory values; medications, history of regular exercise (total of 150 minutes/week), measures of cognition (PCCOG), including Color Word Interference Test (CWIT), Coding, Arithmetic, Matrix Reasoning), clinical assessment of health behavior change, and several patient reported outcomes (PROs) (Edmonton Symptom Assessment System (ESAS), health-related quality of life instrument (EQ5D), anxiety and depression (GAD7, PHQ9) and fatigue (Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F).
These data suggest that people with PASC are more likely to report lower levels of physical well-being, emotional well-being and higher fatigue levels than the non-PASC population. Epinephrine levels correlate statistically significantly with PROs (p<0.05), for overall FACIT-F, as well as the physical and functional subscales. The fatigue severity self-report, PHQ9 and number of symptoms were also significantly correlated. Interleukin-1 beta (IL1b) was inversely correlated with the Physical Well Being (PWB) and Emotional Well Being (EWB) FACIT-F subscales, the GAD7 and the PCCOG scale (p<0.05).
Participants in this observational study of PASC report lower levels of emotional, physical well-being, more fatigue, anxiety and depression than are reported in population norms. Epinephrine and IL1b correlate with these findings and may offer a biological measurement, providing clinically useful information for tracking persistence or recovery. These findings may encourage further study to develop newer treatment approaches.
急性后SARS-CoV-2感染（PASC）的诊断范围很广，指感染SARS-CoV-2超过四周后出现的新的或持续的健康问题。本研究的目的是确定细胞因子、趋化因子或儿茶酚胺水平是否能明确临床状况。
79名参与者亲自参与了PASC研究。他们的平均年龄为51岁，女性占52%，白人占62%，非裔美国人占11%，西班牙裔占37%，平均体重指数为30.5。最常见的症状是疲劳、记忆力减退和呼吸急促。我们提取了共病情况、住院时间和病程以及实验室检查值；用药情况、定期锻炼史（每周总计150分钟）、认知测量（PCCOG），包括颜色词干扰测试（CWIT）、编码、算术、矩阵推理）、健康行为变化的临床评估，以及几项患者报告结局（PROs）（埃德蒙顿症状评估系统（ESAS）、健康相关生活质量量表（EQ5D）、焦虑和抑郁（GAD7、PHQ9）以及疲劳（慢性病治疗功能评估 - 疲劳（FACIT-F））。
这些数据表明，与非PASC人群相比，PASC患者更有可能报告较低的身心健康水平和较高的疲劳水平。肾上腺素水平与PROs在统计学上显著相关（p<0.05），包括总体FACIT-F以及身体和功能子量表。疲劳严重程度自我报告、PHQ9和症状数量也显著相关。白细胞介素-1β（IL1b）与身心健康（PWB）和情绪健康（EWB）FACIT-F子量表、GAD7和PCCOG量表呈负相关（p<0.05）。
在这项PASC观察性研究中，参与者报告的情绪、身心健康水平较低，疲劳、焦虑和抑郁程度高于人群标准。肾上腺素和IL1b与这些发现相关，可能提供一种生物学测量方法，为追踪疾病持续状态或恢复情况提供临床有用信息。这些发现可能会鼓励进一步研究以开发更新的治疗方法。
