CLINICAL AND HEMATOLOGICAL CHARACTERISTICS OF POST-COVID SYNDROME AND ITS RELATIONSHIP WITH THE SEVERITY OF PRIOR COVID-19 AND COMORBID CONDITIONS



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Abstract

Introduction. Post-COVID syndrome (PCS), which develops in 10-35% of cases, is characterized by a spectrum of persistent symptoms sustained for more than 12 weeks post-acute SARS-CoV-2 infection. The aim of the study was to characterize the clinical blood test in patients with varying PCS severity and determine a risk of its development in comorbid pathology while assessing a relation between COVID-19 severity and PCS. Materials and methods. Medical records from 373 patients who underwent an in-depth dispensary examination not earlier than 12 weeks following COVID-19 was conducted at the clinic of the Research Institute of Medical Problems of the North and the Krasnoyarsk Regional Clinical Hospital (Krasnoyarsk). COVID-19 severity was assessed using the WHO Clinical Progression Scale (WHO-CPS). PCS general characteristics were assessed using the Post-COVID-19 Functional Status Scale (PCFS). Comorbidity was assessed using the Age-Specific Charlson Comorbidity Index (ACCI). The type and characteristics of the immune response were assessed using the PROTIST software. Results. The ACCI index in individuals with moderate and severe COVID-19/moderate and severe PCS was significantly higher than in groups without PCS and with mild COVID-19/mild PCS. In patients who had moderate/severe COVID-19, the development of moderate/severe PCS was accompanied by elevated CRP level in 34.5% of cases (20 patients), a peaked rate among all groups. In the group with moderate and severe COVID-19/moderate and severe PCS, the leukocyte level is lower than in group without PCS, but higher than in group with mild COVID-19/mild PCS. The absolute granulocyte level in this group is higher than in other groups. Conclusion. It has been found out that COVID-19 severity is a prognostic factor for PCS development. While assessing immune response types, it was found that more than 50% of patients with moderate/severe PCS show activated innate immunity, while only 25% were non-reactive/normal. The presence of these PCS phenotypes underlies a need for a personalized approach while recommending anti-inflammatory therapy.

About the authors

Ivan S. Sadowski

Scientific and Research Institute of Medical Problems of the North of the Federal Research Centre "Krasnoyarsk Scientific Centre of the Siberian Branch of the Russian Academy of Science", Krasnoyarsk, Russian Federation

Email: sadovskii24@rambler.ru
ORCID iD: 0000-0003-0338-4647
SPIN-code: 3624-9788

postgraduate student, junior research fellow of the cellular-molecular physiology and pathology laboratory of the Federal Research Center «Krasnoyarsk Science Center» of the Siberian Branch of the Russian Academy of Sciences, Scientific Research Institute of medical problems of the North, Krasnoyarsk, Russian Federation

Russian Federation, 660022, Krasnoyarsk, P.Zheleznyaka Str., 3 g

Andrey A. Savchenko

Scientific and Research Institute of Medical Problems of the North of the Federal Research Centre "Krasnoyarsk Scientific Centre of the Siberian Branch of the Russian Academy of Science", Krasnoyarsk, Russian Federation

Email: aasavchenko@yandex.ru
SPIN-code: 3132-8260
Scopus Author ID: 7202769821
ResearcherId: S-5099-2016

PhD, MD (Medicine), Professor, Head of the Laboratory of Cellular-Molecular Physiology and Pathology

Russian Federation, Krasnoyarsk

E. V. Kasparov

Scientific and Research Institute of Medical Problems of the North of the Federal Research Centre "Krasnoyarsk Scientific Centre of the Siberian Branch of the Russian Academy of Science", Krasnoyarsk, Russian Federation

Email: impn@impn.ru
ORCID iD: 0000-0002-5988-1688
SPIN-code: 8848-3659
Scopus Author ID: 55274733200

PhD, MD (Medicine), Professor, Director of the Scientific Research Institute of Medical Problems of the North, Deputy Director for Scientific Work

Russian Federation, 660022, Krasnoyarsk, Partizana Zheleznyaka str., 3g

Irina V. Demko

Federal State Budgetary Educational Institution of Higher Education «Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnoyarsk, Russia

Email: demko64@mail.ruIrina
ORCID iD: 0000-0001-8982-5292
SPIN-code: 6520-3233
Scopus Author ID: 22957140300
ResearcherId: O-9740-2015

MD, Professor. of the Department of Hospital Therapy and Immunology with a PO course, Krasnoyarsk State Medical University named after I.I. VF Voino-Yasenetsky, Krasnoyarsk, Russian Federation

Russian Federation, 660022, Красноярский край, г. Красноярск, ул. Партизана Железняка, зд. 1

Elena P. Tikhonova

Federal State Budgetary Educational Institution of Higher Education «Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnoyarsk, Russia

Email: tihonovaep@mail.ru
ORCID iD: 0000-0001-6466-9609
SPIN-code: 8376-7373

DSc (Medicine), Professor, Head of the Department of Infectious Diseases and Epidemiology with a course of Postgraduate Education

Russian Federation, Krasnoyarsk

Elena A. Sobko

Federal State Budgetary Educational Institution of Higher Education «Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnoyarsk, Russia

Email: sobko29@mail.ru
ORCID iD: 0000-0002-9377-5213
SPIN-code: 9132-6756
Scopus Author ID: 55775133600
ResearcherId: AAG-7668-2019

MD, Professor. of the Department of Hospital Therapy and Immunology with a PO course, Krasnoyarsk State Medical University named after I.I. VF Voino-Yasenetsky, Krasnoyarsk, Russian Federation

Russian Federation, 660022, Красноярский край, г. Красноярск, ул. Партизана Железняка, зд. 1

Olga S. Kruglova

Federal State Budgetary Educational Institution of Higher Education «Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnoyarsk, Russia

Email: kruglovaos95@gmail.com
ORCID iD: 0000-0003-1041-6088
SPIN-code: 5417-9849
Scopus Author ID: 58525523400
ResearcherId: 4988502

senior lecturer of the Department of Hospital Therapy and Immunology with the course of PO, Krasnoyarsk State Medical University named after I.I. VF Voino-Yasenetsky, Krasnoyarsk, Russian Federation

Russian Federation, 660022, Красноярский край, г. Красноярск, ул. Партизана Железняка, зд. 1

Alexandr G. Borisov

Scientific and Research Institute of Medical Problems of the North of the Federal Research Centre "Krasnoyarsk Scientific Centre of the Siberian Branch of the Russian Academy of Science", Krasnoyarsk, Russian Federation

Author for correspondence.
Email: 2410454@mail.ru
ORCID iD: 0000-0002-9026-2615
SPIN-code: 9570-2254
Scopus Author ID: 7201889370
ResearcherId: S-5081-2016

PhD (Medicine), Leading Researcher, Laboratory of Cellular-Molecular Physiology and Pathology

Russian Federation, Krasnoyarsk

References

  1. Бердюгина О.В. Постковидный синдром: к дискуссии о сроках наступления // Инфекция и иммунитет. - 2024. - Т. 14. - №3. - C. 476-482. Berdiugina O.V. Post-COVID-19 syndrome: a discussion of onset timing // Russian Journal of Infection and Immunity. - 2024. - Vol. 14. - N. 3. - P. 476-482. doi: 10.15789/2220-7619-PCS-16766
  2. Блохин А.А., Шишкин А.Н., Минкин С.Р. Методы оценки коморбидности и ее роль у пациентов с кардиологической патологией // Вестник Санкт-Петербургского университета. Медицина. 2023. Т. 18. Вып. 2. С. 94–111. Blokhin, A.A., Shishkin, A.N., and Minkin, S.R., 2023. Methods for assessing comorbidity and its role in patients with cardiac pathology. Vestnik Sankt-Peterburgskogo Universiteta. Meditsina [Bulletin of Saint Petersburg University. Medicine]. Vol. 18, No. 2, pp. 94–111. doi.org/10.21638/spbu11.2023.201
  3. Борисов Р.Н., Здзитовецкий Д.Э., Каспаров Э.В., Савченко А.А., Борисов С.А., Бердников Д.С., Говоруха Е.С., Болдырев П.Н. Типы реакции иммунной системы и их характеристика у больных распространенным гнойным перитонитом. Сибирское медицинское обозрение. 2019;(5):80-87. Borisov R.N., Zdzitovetskii D.E., Kasparov E.V., Savchenko A.A., Borisov S.A., Berdnikov D.S., Govorukha E.S., Boldyrev P.N. Types of immune system reactions and their characteristic in patients with generalized purulent peritonitis. Siberian Medical Review.2019;(5):80-87 doi: 10.20333/2500136-2019-5-80-87
  4. Борисов А.Г., Савченко А.А., Каспаров Э.В., Борисов С.А., Маценко М.В., Навицкий А.И. ПРОТИСТ (ПРограмма Оценки Типа реакции Иммунной СисТемы) // Свидетельство о государственной регистрации программы для ЭВМ № 2017619658. Правообладатель: ООО «МедБиоТех».-Заявка № 2017616390 от 03.07.2017.-Зарегистрирована 01.09.2017.- 2 с. Borisov A.G., Savchenko A.A., Kasparov E.V., Borisov S.A., Matsenko M.V., Navitsky A.I. PROTIST (Program for Assessing the Type of Reaction of the Immune System) // Certificate of state registration of the computer program No. 2017619658. Copyright holder: MedBioTech LLC. - Application No. 2017616390 dated 03.07.2017. - Registered 01.09.2017. - 2 pp. https://www.fips.ru/publication-web/publications/document?type=doc&tab=PrEVM&id=F9C5E4A6-3744-466D-B8B2-9DCF16349205
  5. Плоскирева А.А., Горелов А.В., Летюшев А.Н., Омарова Х.Г., Музыка А.Д. Постковидный синдром: классификация клинических форм // Вестник Российской академии медицинских наук. - 2024. - Т. 79. - №5. - C. 416–423. Ploskireva A.A., Gorelov A.V., Letyushev A.N., Omarova K.G., Muzyka A.D. Post COVID Syndrome: the Classification of Clinical Forms // Annals of the Russian academy of medical sciences. - 2024. - Vol. 79. - N. 5. - P. 416–423. doi: 10.15690/vramn15995
  6. Садовский И.С., Круглова О.С., Савченко А.А., Собко Е.А., Каспаров Э.В., Демко И.В., Борисов А.Г. Комплексные показатели воспаления у больных с постковидным синдромом // Российский иммунологический журнал. - 2023. - Т. 26. - №1. - C. 77-86. Sadovskiy I.S., Kruglova O.S., Savchenko A.A., Sobko E.A., Kasparov E.V., Demko I.V., Borisov A.G. Complex inflammation indexes in patients with post-COVID syndrome // Russian Journal of Immunology. - 2023. - Vol. 26. - N. 1. - P. 77-86. doi: 10.46235/1028-7221-1186-CII
  7. Aldhawyan AF, BuSaad MA, Alamri BA, Alsaihati MI, Alanazi BS, Alanazi RA, Bahamdan AS. Evaluating the Predictors of Persistent Long COVID Symptoms and Their Severity in COVID-19 Survivors 1 Year After Infection. J Prim Care Community Health. 2024 Jan-Dec;15:21501319241295686. doi: 10.1177/21501319241295686.
  8. PMID: 39471195;
  9. PMCID: PMC11528748.
  10. Anaya JM, Rojas M, Salinas ML, Rodríguez Y, Roa G, Lozano M, Rodríguez-Jiménez M, Montoya N, Zapata E; Post-COVID study group; Monsalve DM, Acosta-Ampudia Y, Ramírez-Santana C. Post-COVID syndrome. A case series and comprehensive review. Autoimmun Rev. 2021 Nov;20(11):102947. doi: 10.1016/j.autrev.2021.102947. Epub 2021 Sep 10.
  11. PMID: 34509649;
  12. PMCID: PMC8428988.
  13. Bassami F, Yavari M, Feizi A, Siavash M, Akbari M, Karimifar M. Association between high-sensitivity C-reactive protein and diabetic nephropathy: a systematic review and meta-analysis. BMC Nephrol. 2025 Jul 26;26(1):418. doi: 10.1186/s12882-025-04358-y.
  14. PMID: 40713563.
  15. Charlson M., Szatrowski T.P., Peterson J., Gold J. Validation of a combined comorbidity index. J Clin Epidemiol, Nov. 1994, Vol. 47, no. 11, pp. 1245-1251. doi: 10.1016/0895-4356(94)90129-5
  16. Chen C., Haupert S.R., Zimmermann L., Shi X., Fritsche L.G., Mukherjee B. Global Prevalence of Post-Coronavirus Disease 2019 (COVID-19) Condition or Long COVID: A Meta-Analysis and Systematic Review. J Infect Dis, Nov. 2022, Vol. 226, no. 9, pp. 1593-1607. doi: 10.1093/infdis/jiac136
  17. Falsetti L, Zaccone V, Santoro L, Santini S, Guerrieri E, Giuliani L, Viticchi G, Cataldi S, Gasbarrini A, Landi F, Santoliquido A, Moroncini G, On Behalf Of Gemelli Against Covid-Post-Acute Care Study Group. The Relationship between Post-COVID Syndrome and the Burden of Comorbidities Assessed Using the Charlson Comorbidity Index. Medicina (Kaunas). 2023 Aug 31;59(9):1583. doi: 10.3390/medicina59091583.
  18. PMID: 37763702;
  19. PMCID: PMC10533175.
  20. Fernández-de-Las-Peñas C., Palacios-Ceña D., Gómez-Mayordomo V., Cuadrado M.L., Florencio L.L. Defining Post-COVID Symptoms (Post-Acute COVID, Long COVID, Persistent Post-COVID): An Integrative Classification. Int J Environ Res Public Health, Mar. 2021, Vol. 18, no. 5, pp. 2621. doi: 10.3390/ijerph18052621
  21. Kirsh S., Ling M., Jassal T., Pitre T., Pigott T., Zeraatkar D. Values and preferences in COVID-19 public health guidelines: A systematic review. J Clin Epidemiol, Jul. 2024, no. 174, pp. 111473. doi: 10.1016/j.jclinepi.2024.111473
  22. Klok F.A., Boon G.J.A.M., Barco S., Endres M., Geelhoed J.J.M., Knauss S., Rezek S.A., Spruit M.A., Vehreschild J., Siegerink B. The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. European Respiratory Journal, 2020, Vol. 56, no. 1, pp. 1-3 doi: 10.1183/13993003.01494-2020
  23. Kurmangaliyeva SS, Madenbayeva AM, Urazayeva ST, Bazargaliyev YS, Kudabayeva KI, Kurmangaliyev KB. The Role of Memory T-Cell Mediated Immunity in Long-term COVID-19: Effects of Vaccination Status. Iran J Med Sci. 2025 Feb 1;50(2):61-68. doi: 10.30476/ijms.2024.104003.3744. PMID: 40026299;
  24. PMCID: PMC11870859.
  25. Mohan A, Iyer VA, Kumar D, Batra L, Dahiya P. Navigating the Post-COVID-19 Immunological Era: Understanding Long COVID-19 and Immune Response. Life (Basel). 2023 Oct 26;13(11):2121. doi: 10.3390/life13112121.
  26. PMID: 38004261; PMCID: PMC10672162.
  27. Ne CKH, Suaini NHA, Aung WT, Ong KGS, Samuel M, Tham EH. Impact of COVID-19 pandemic on adults and children with atopic dermatitis and food allergy: Systematic review. J Allergy Clin Immunol Glob. 2023 Oct 18;3(1):100181. doi: 10.1016/j.jacig.2023.100181.
  28. PMID: 38026506;
  29. PMCID: PMC10665685.
  30. Notarte KI, de Oliveira MHS, Peligro PJ, Velasco JV, Macaranas I, Ver AT, Pangilinan FC, Pastrana A, Goldrich N, Kavteladze D, Gellaco MML, Liu J, Lippi G, Henry BM, Fernández-de-Las-Peñas C. Age, Sex and Previous Comorbidities as Risk Factors Not Associated with SARS-CoV-2 Infection for Long COVID-19: A Systematic Review and Meta-Analysis. J Clin Med. 2022 Dec 9;11(24):7314. doi: 10.3390/jcm11247314.
  31. PMID: 36555931;
  32. PMCID: PMC9787827.
  33. Pelà G, Goldoni M, Solinas E, Cavalli C, Tagliaferri S, Ranzieri S, Frizzelli A, Marchi L, Mori PA, Majori M, Aiello M, Corradi M, Chetta A. Sex-Related Differences in Long-COVID-19 Syndrome. J Womens Health (Larchmt). 2022 May;31(5):620-630. doi: 10.1089/jwh.2021.0411. Epub 2022 Mar 25.
  34. PMID: 35333613.
  35. Premraj L, Kannapadi NV, Briggs J, Seal SM, Battaglini D, Fanning J, Suen J, Robba C, Fraser J, Cho SM. Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: A meta-analysis. J Neurol Sci, Mar. 2022, no. 434, pp. 120162 doi: 10.1016/j.jns.2022.120162
  36. Putilina M.V., Mutovina Z.Y., Kurushina O.V., Khalilova D.M., Saverskaya E.N., Stepanova S.B., Khoreva M.A., Starikov A.S. Determination of the Prevalence of Postcovid Syndrome and Assessment of the Effectiveness of the Drug Cortexin in the Treatment of Neurological Disorders in Patients with Postcovid Syndrome. Results of the CORTEX Multicenter Clinical and Epidemiological Observational Program. Neurosci Behav Physiol, 2022, Vol. 52, no. 6, pp. 836-841. doi: 10.1007/s11055-022-01307-2
  37. Robu Popa D., Melinte O.E., Dobrin M.E., Cernomaz A.T., Grigorescu C., Nemes A.F., Todea D.A., Vulturar D.M., Grosu-Creangă I.A., Lunguleac T., Trofor A.C. Laboratory Diagnostics Accuracy for COVID-19 versus Post-COVID-19 Syndrome in Lung Disease Patients with Multimorbidity. J Pers Med, Jan. 2024, Vol. 14, no. 2, pp. 171. doi: 10.3390/jpm14020171
  38. Rubio-Rivas M., Mora-Luján J.M., Formiga F., Arévalo-Cañas C., Lebrón Ramos J.M., Villalba García M.V., Fonseca Aizpuru E.M., Díez-Manglano J., Arnalich Fernández F., Romero Cabrera J.L., García García G.M., Pesqueira Fontan P.M., Vargas Núñez J.A., Freire Castro S.J., Loureiro Amigo J., Pascual Pérez M.L.R., Alcalá Pedrajas J.N., Encinas-Sánchez D., Mella Pérez C., Ena J., Gracia Gutiérrez A., Esteban Giner M.J., Varona J.F., Millán Núñez-Cortés J., Casas-Rojo J.M. SEMI-COVID-19 Network. WHO Ordinal Scale and Inflammation Risk Categories in COVID-19. Comparative Study of the Severity Scales. J Gen Intern Med, Jun. 2022, Vol. 37, no. 8, pp. 1980-1987. doi: 10.1007/s11606-022-07511-7
  39. Sk Abd Razak R, Ismail A, Abdul Aziz AF, Suddin LS, Azzeri A, Sha'ari NI. Post-COVID syndrome prevalence: a systematic review and meta-analysis. BMC Public Health. 2024 Jul 4;24(1):1785. doi: 10.1186/s12889-024-19264-5.
  40. PMID: 38965510;
  41. PMCID: PMC11223303.
  42. Wang J, Zhang X, Deng H, Tan Y. The Effect of the COVID-19 Pandemic Lockdown on Self-Harm: A Meta-Analysis. Alpha Psychiatry. 2025 Apr 22;26(2):39868. doi: 10.31083/AP39868.
  43. PMID: 40352079;
  44. PMCID: PMC12059762.

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