Persistence Dysregulation of Serum Proteins and Immunoglobulins in Post-Acute COVID-19: A Prospective Cohort Study
Authors
-
Marzieh Rohani-Rasaf
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0002-7945-7542
-
Rajab Mardani
- Department of Viral Vaccines Production, Research and Production Complex, Pasteur Institute of Iran, Tehran, Iran.
https://orcid.org/0000-0001-7730-3040
-
Seyed Dawood Mousavi Nasab
- Department of Arboviruses and Viral Hemorrhagic Fevers, Pasteur Institute of Iran, Tehran, Iran.
https://orcid.org/0000-0002-4831-3108
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Hossein Hosseini
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
https://orcid.org/0000-0003-4859-7291
-
Asie Sadeghi
- Department of Clinical Biochemistry, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
https://orcid.org/0000-0001-5241-9856
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Maryam Teimouri *
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0002-3904-3951
DOI:
https://doi.org/10.22100/jkh.v20i3.3515Abstract
Introduction: This prospective cohort study aimed to assess serum albumin, total proteins, globulin fractions (alpha1, alpha2, beta1, beta2, gamma), and immunoglobulin subclasses (IgG1, IgG2, IgM, kappa, and lambda light chains) at 30 and 60 days after the onset of symptoms in non-vaccinated COVID-19 recovered patients.
Methods: Serum protein fractions were measured using capillary electrophoresis. Immunoglobulin subclasses were assessed using ELISA. Turbidometry is used for the measurement of kappa and lambda light chains.
Results: At 30 and 60 days post-COVID-19 infection, serum albumin and beta2-globulin levels declined, while alpha1-, alpha2-, and beta1-globulin fractions remained elevated above reference values. Between these time points, albumin increased significantly (P<0.001), accompanied by reductions in alpha1 and alpha2 fractions (P=0.016 and <0.001, respectively). On day 30, ICU patients exhibited lower albumin (P=0.047) and higher alpha1 and alpha2 levels compared with non-ICU patients (P<0.001). By day 60, beta2-globulin and gamma globulin showed further reductions in comparison with day 30 (P=0.030 and 0.001, respectively), although gamma globulin remained above the normal reference range. Severe cases at day 60 demonstrated significantly lower IgG2 levels (P=0.045).
Conclusion: In summary, post-acute COVID-19 is associated with prolonged abnormalities in serum protein fractions and immunoglobulin profiles, particularly in patients with severe disease. Serial assessment of serum proteins can be used as an important tool for monitoring recovery and long-term sequelae and guiding vaccine timing at the time of recovery.
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