Abstract
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), poses several challenges to clinicians, due to its unpredictable clinical course. The identification of laboratory biomarkers, specific cellular, and molecular mediators of immune response could contribute to the prognosis and management of COVID-19 patients. Of utmost importance is also the detection of differentially expressed genes, which can serve as transcriptomic signatures, providing information valuable to stratify patients into groups, based on the severity of the disease. The role of biomarkers such as IL-6, procalcitonin, neutrophil–lymphocyte ratio, white blood cell counts, etc. has already been highlighted in recently published studies; however, there is a notable amount of new evidence that has not been summarized yet, especially regarding transcriptomic signatures. Hence, in this review, we assess the latest cellular and molecular data and determine the significance of abnormalities in potential biomarkers for COVID-19 severity and persistence. Furthermore, we applied Gene Ontology (GO) enrichment analysis using the genes reported as differentially expressed in the literature in order to investigate which biological pathways are significantly enriched. The analysis revealed a number of processes, such as inflammatory response, and monocyte and neutrophil chemotaxis, which occur as part of the complex immune response to SARS-CoV-2.
Highlights
The COVID-19 pandemic poses a global health threat as it is responsible for more than 426 million cases of infection and 5.89 million deaths since December 2019, while it raises challenges in clinical assessment of the disease severity
IL-16, which is found overexpressed, characterizes the initiation of humoral response, promoting CD4+ T cells and circulating dendritic cells (DCs)’ migration into lymphoid organs and is considered to be a characteristic of long-term recovery PBs [62]. It has been almost two years since the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) emerged and was designated as the causative agent of COVID-19, an infection which presents with great clinical variability, resulting in a great variety of distinctive features and extensive disease distribution, with extrapulmonary manifestations
The identification of a number of hematological and immunological markers, as well as a panel of genes that have potential as biomarkers associated with disease progression from mild/moderate to severe/critical, will ensure the successful stratification of patients and predict immune responses, enabling effective management
Summary
The COVID-19 pandemic poses a global health threat as it is responsible for more than 426 million cases of infection and 5.89 million deaths since December 2019 (https://covid19.who.int/, accessed on 1 February 2022), while it raises challenges in clinical assessment of the disease severity. Recent studies have shown that elderly patients experience more severe clinical manifestations and increased risk of mortality compared to younger individuals, who are less vulnerable to severe disease [4,6–10]. They are considered to be important contributors in the formation of molecular transmission clusters, groups of individuals who are associated with each other by SARS-CoV-2 transmission, representing a risk network [11]. An estimated 10% of COVID-19 survivors are considered as long-haulers and experience ongoing symptoms such as cough, dyspnea, chest pain, headache, difficulty concentrating, arthralgia, muscle pains, fatigue, and olfactory dysfunction for an extended period of time [12,13] Experiencing such a debilitating disease in its severe form can result to prolonged recovery.
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