Long-term clinical and biochemical residue after COVID-19 recovery

Abstract

Background The long-term health consequences of coronavirus disease 2019 (COVID-19) are still unclear. The majority of previous trials addressed the post-COVID-19 symptoms through comprehensive medical questionnaires for relatively short periods after recovery. We tried to detect the potential pathological clinical signs and biochemical residue which persist for more than 3 months after the negative real-time polymerase chain reaction (RT-PCR) test of SARS-CoV-2. Results Among 120 COVID-19 survivors of mean age 38.29 and 55.6% male proportion, systolic blood pressure was significantly elevated (P=0.001). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), D-dimer showed higher values in COVID-19 survivors (P< 0.001). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl trans-peptidase (GGT), and alkaline phosphatase (ALP) were significantly elevated in contrast to serum albumin that was reduced in COVID-19 survivors (P ≤0.001). Serum lipase, amylase and albuminuria were higher in COVID-19 survivors (P ≤0.001). Regression analysis (AOR, 95% CI) showed that ESR (P = 0.014), haemoglobin concentration (P = 0.039), serum lipase (P= 0.018), blood urea nitrogen (P= 0.003), albuminuria (P= 0.046), 25(OH) vitamin D (P= 0.002), and serum uric acid (P= 0.005) were the significant predictors of COVID-19 survivors (94.8% an overall prediction). Conclusion COVID-19 survivors experienced residual significant clinical and biochemical alterations that necessitate comprehensive medical care and close follow-up for longer periods.

Chronic fatigue, depression and anxiety symptoms in Long COVID are strongly predicted by neuroimmune and neuro-oxidative pathways which are caused by the inflammation during acute infection

“…In accordance with our previous study (Al-Hakeim, Al-Rubaye et al 2022), we found that mild elevations in CRP contributed to the physio-affective phenome of Long COVID. Previous studies showed elevated CRP in COVID-19 patients following 2-3 months of full recovery (Gameil, Marzouk et al 2021, Mandal, Barnett et al 2021). In the liver, CRP production is triggered by IL-6 (Kuta and Baum 1986) and elevated CRP has toxic effects on endothelial cells and raises the permeability of BBB, thus enhancing the development of neurodegenerative and cerebrovascular diseases (Song, Kim et al 2009, Windgassen, Funtowicz et al 2011, Hsuchou, Kastin et al 2012, Ge, Xu et al 2013, Belin, Devic et al 2020.…”

Osteonecrosis with Concomitant Bacterial Osteomyelitis of Both Hips and a Knee in a Post–COVID-19 Patient

“…Our patient was young, with no comorbidities and no evidence of UTI or active pneumonia was found. Gameil et al found that inflammatory markers such as ESR and CRP remain significantly raised even 3 months after recovery from COVID-19 infection 18 . In our patient, the ESR and CRP were significantly raised which we had attributed to the post–COVID-19 alterations.…”

The osteo-metabolic phenotype of COVID-19: an update

“…Finally, in COVID-19 survivors, more than 3 months after negative test for SARS-CoV-2, a non-significant difference in calcium levels was observed compared to healthy matched for age and sex subjects, possibly confirming the casual relationship between COVID-19 and hypocalcemia, and its transient nature once the patient recovered from the acute viral syndrome [ 35 ]. These data does not entirely support a routine estimation of serum calcium in all post-COVID-19 patients [ 36 ].…”