Post COVID-19 Physical Performance and Functional Capacity

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Original Research
22 July 2021
Serum Metabolic Profile in Patients With Long-Covid (PASC) Syndrome: Clinical Implications
Evasio Pasini
5 more and 
Francesco S. Dioguardi
Schematic representation of the link between SARS-CoV2 infection and metabolic impairment in infected cell and Long-COVID/PASC syndrome.

Background: Many patients who have been suffering by COVID-19 suffer of long-COVID syndrome, with symptoms of fatigue and muscular weakness that characterize post-acute sequelae SARS-CoV-2 infection (PASC). However, there is limited knowledge about the molecular pathophysiology, and about the serum profile of these patients.

Methods: We studied the blood serum profile of 75 selected patients, with previous confirmed COVID-19, 2 months after hospital discharge, who reported new-onset fatigue, muscle weakness and/or dyspnea not present prior to the virus infection and independently from concomitant diseases and/or clinical conditions.

Results: All patients had very high serum concentrations of ferritin and D-Dimer. 87 and 72% of patients had clinically significant low levels of hemoglobin and albumin, respectively. Seventy three percentage had elevations in erythrocyte sedimentation rate and CRP. Twenty seven percentage had elevations in LDH.

Conclusions: The co-existence of patient symptoms along with blood markers of coagulation, protein disarrangement and inflammation suggests ongoing alterations in the metabolism, promoting an inflammatory/hypercatabolic state which maintains a vicious circles implicated in the persistence of PASC. The persistence of altered D-Dimer levels raises the possibility of long-term risks of thromboembolic disease. All these markers levels should be accurately evaluated in the long-term follow-up, with individualized consideration for prophylactic nutritional, anti-inflammatory and/or anticoagulant therapy if indicated.

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