Biomarcadores e fatores de risco na condição Pós-COVID: revisões sistematizadas da literatura

Abstract

Introduction: Post-COVID status (PCS), also known as long COVID, refers to the persistence of signs and symptoms after the acute phase of SARS-CoV-2 infection, significantly affecting the quality of life of affected individuals. Despite its high prevalence, gaps remain in the diagnosis, monitoring, and treatment of PCS, especially within the Unified Health System (SUS), where specific public policies and clinical guidelines are lacking. Given this scenario, this study aimed to gather and systematize scientific evidence and identify potential biomarkers and risk factors involved in PCS, focusing on their clinical implications and potential application in healthcare practice. Methodology: The research was conducted using two distinct and complementary strategies. The first consisted of a scoping review, which identified and mapped the main clinical and prognostic biomarkers described in the literature between 2020 and 2024. The second was a systematic review with meta-analysis, focused on the quantitative analysis of the association between the interleukins IL-1β, IL-6, and IL-8 and CPC, as well as the main risk factors for it. Results: The scoping review's findings demonstrated the relevance of inflammatory, endothelial, and autoimmune markers, with a greater emphasis on the interleukins IL-1β, IL-6, and IL-8. However, the following markers were also reported: CRP, D-dimer, VEGF-A, MMPs, MPO, ANA, and HMGB1. Interleukins reflect a dysregulated and sustained immune response, typical of CPC, requiring further studies. The systematic review with meta-analysis demonstrated significant elevations in interleukins IL-6 (SMD = 0.84; 95% CI: 0.38–1.31) and IL-8 (SMD = 0.50; 95% CI: 0.02–0.98) in patients with CPC, suggesting a persistent and sustained inflammatory state, while IL-1β showed only an upward trend, without statistical significance. Subgroup analysis indicated that advanced age, severity of acute COVID-19, and the presence of comorbidities such as hypertension and obesity are associated with higher levels of these interleukins and an increased risk of CPC. Conclusion: The findings reinforce that the identification and monitoring of biomarkers, especially IL-6 and IL-8, can contribute to the advancement of understanding of CPC and support more precise clinical strategies. Although they cannot yet be considered established diagnostic markers, their relevance as promising candidates highlights the need for further clinical studies and investment in translational research. The future incorporation of these findings into the SUS routine may represent an important step in tackling the long form in Brazil.