The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors
Elaheh Abiri, Ali Abiri, Salman Daneshi, Rasoul Raesi
BMC Infectious Diseases, doi:10.1186/s12879-025-11419-y
Background Persistent symptoms and complications reported by many patients for more than four weeks after contracting coronavirus disease 2019 are referred to as post-COVID-19 syndrome. These persistent symptoms can occur in individuals with both mild and severe COVID-19, though the underlying pathophysiological mechanisms remain poorly understood. This study aims to explore post-COVID-19 syndrome from a biological perspective, focusing on genomic instability.
Methods In this cross-sectional study, the comet assay method was employed in March 2024 to evaluate the level of DNA damage in 29 patients to examine the post-COVID-19 syndrome state at Kausar Semnan Hospital in Iran. Levels of DNA damage were assessed using the alkaline comet assay in patients hospitalized for COVID-19, four weeks after a positive RT-PCR test. Patients were categorized based on pneumonia severity: mild (11 patients in non-ICU), moderate (10 patients in ICU and non-intubated), and severe/critical (8 patients in ICU and intubated). Ten healthy individuals who tested negative for COVID-19 were considered as a control group. Data were analyzed using descriptive and inferential statistical tests at a significance level of p < 0.01 in GraphPad Prism 9 software.
Results Post-COVID-19 patients exhibited significantly higher levels of DNA damage compared to healthy controls. The highest DNA damage was observed in intubated-ICU patients (mean DNA damage: 29.5%), followed by nonintubated-ICU patients (mean: 24.3%), non-ICU patients (mean: 19.1%), and healthy controls (mean: 9.4%). These findings suggest a clear correlation between COVID-19 severity and increased genomic instability.
Conclusion The results of this study highlight the prevalence of DNA damage in post-COVID-19 patients, which may explain long-term genomic instability and associated health complications. The findings underscore the importance of further research into the pathophysiological mechanisms of post-COVID-19 syndrome, particularly its impact on genomic stability. This study contributes to the growing evidence that post-COVID-19 syndrome is a complex condition with virus-specific abnormalities affecting multiple biological pathways. Future studies should focus on understanding these mechanisms to develop targeted interventions for long-term COVID-19 survivors.
Abbreviations
COVID-19 Coronavirus Disease 2019
Declarations Ethics approval and consent to participate All procedures performed in the study involving human participants were conducted according to the ethical standards of the institutional and national research committee and of the 1975 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Biomedical Research Ethics Committee of Damghan Islamic Azad University, which issued the study's code of ethics (IR.IAU. DAMGHAN.REC.1400.005). Before data collection, written informed consent was obtained from all subjects participating in the study. To comply with ethical considerations, all medical record information was kept confidential. The names and surnames of participants were not used for data collection, and data collection was carried out after obtaining the code of ethics from Damghan Islamic Azad University.
Consent for publication Not applicable.
Competing interests The authors declare no conflict of interest, financial or otherwise.
Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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