Objective:

To investigate blood biomarker profiles over a one-year follow-up in a cohort of moderate and severe COVID-19 patients, focusing on markers of renal function, muscle injury, cardiovascular risk, immune derangement, chronic inflammation, and matrix remodeling, to better understand long COVID.

Approach:

Key Findings:

• Participants with severe COVID-19 showed persistent immune dysregulation and systemic inflammation at approximately 1 year.
• Higher concentrations of inflammatory mediators and cytokines were observed in severe cases compared to moderate cases and controls.
• Sustained elevations in MMP-2 and MMP-9 were noted in severe cases.
• Alterations in complete blood count-derived indices, including specific ratios like CRP to lymphocyte ratio, were observed over time in severe cases.

Interpretation:

The study delineates a persistent inflammatory and matrix-remodeling signature up to 1 year after severe COVID-19, based on longitudinal biomarker profiles rather than symptom-defined long COVID-19 outcomes, highlighting the need for targeted clinical interventions.

Limitations:

• Prospective prognostic validation and clinical endpoint data are still required, limiting the ability to draw definitive conclusions about long-term outcomes.
• Limited information regarding markers in subjects affected by moderate and severe acute COVID-19 1 year after infection may affect the generalizability of the findings.

Conclusion:

The findings suggest that a biomarker panel may help inform future studies of post-acute risk stratification and targeted interventions, potentially improving management strategies for long COVID.

Sources:

• Clinical Trial Registration
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