Dados do Trabalho

Título

Association of systemic inflammation and long-term dysfunction in COVID-19 patients: a prospective cohort

Objetivo

COVID-19 has significant long-term impacts, including a chronic syndrome known as long-COVID, characterized by persistent symptoms post-recovery. The inflammatory response during acute infection is hypothesized to influence long-term outcomes. This study aimed to identify inflammatory biomarkers predictive of functional outcomes one year after hospital discharge.

Métodos

A prospective cohort study was conducted with 213 COVID-19 patients admitted to ICUs in Southern Brazil between June and November 2020. After exclusions and follow-ups, 109 patients were evaluated for one-year post-discharge. Plasma levels of Th1 (TNF-α, INF-γ, IL-12), Th2 (IL-4, IL-5, IL-6, IL-10, IL-13), and Th17 (IL-17, IL-22) cytokines were measured. Functional outcomes in psychiatric, cognitive, general health, and health perception domains were assessed. Statistical analyses included multivariate regression, regularized partial correlation network analysis, and K-means clustering. Plasma cytokine levels, demographic, and clinical characteristics predicted four functional outcome domains.

Resultados

Hyperinflammatory phenotype correlated with worse psychiatric and general health outcomes. IL-12 and INF-γ were identified as central biomarkers on network connectivity influencing long-term outcomes. Length of hospital stay, and years of education were significant predictors for multiple outcomes. The network analysis highlighted complex interconnections among immune markers and clinical variables, elucidating their roles in long-term health. Inflammatory biomarkers are associated with different functional domains of long-COVID one year after hospital discharge. Hyperinflammatory phenotype predicts worse psychiatric and general health outcomes, suggesting that inflammatory pathways play a crucial role in long-term recovery.

Conclusão

These findings support using biomarkers for patient stratification and indicate potential targets for therapeutic interventions.