Routine lab tests are not reliable for diagnosing Long COVID, according to a new study. The research found that no clinical lab values could serve as biomarkers, highlighting the need to focus on symptoms for diagnosis.
A new study found that most routine laboratory tests are not reliable for diagnosing Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 infection (PASC).
The study, published in Annals of Internal Medicine, found no reliable biomarker among 25 routine clinical laboratory values for prior infection, PASC, or specific types of PASC clusters. This suggests none of these routine labs can serve as a clinically useful biomarker of PASC.
"Our study shows patients can have severe Long COVID with normal lab results. This suggests doctors should not focus on the results of blood panels to diagnose Long COVID but should focus more on symptoms and ways to help patients get relief by treating their symptoms," said the study's first author, Kristine Erlandson, MD, a professor in the Division of Infectious Diseases at the University of Colorado Anschutz Medical Campus.
Seven percent of all adults in the U.S., nearly 18 million people, currently have long COVID, according to the Agency for Healthcare Research and Quality's Medical Expenditure Panel Survey.
"Our challenge is to discover biomarkers that can help us quickly and accurately diagnose long COVID to ensure people struggling with this disease receive the most appropriate care as soon as possible," said David Goff, MD, PhD, director for the Division of Cardiovascular Sciences at the NIH's National Heart, Lung, and Blood Institute. "Long COVID symptoms can prevent someone from returning to work or school, and may even make everyday tasks a burden, so the ability for rapid diagnosis is key."
Large-Scale Study and Findings
This study was funded by the National Institutes of Health's (NIH) Researching COVID to Enhance Recovery (RECOVER) Initiative. The RECOVER initiative includes multiple research studies that involve thousands of participants from across the country. In Colorado, these studies take place at the Colorado Clinical and Translational Sciences Institute (CCTSI) at CU Anschutz.
To investigate clinical laboratory markers of SARS-CoV-2 and PASC, the researchers examined data from nearly 10,000 adults with and without SARS-CoV-2 infection. The researchers recruited from over 80 enrolling sites across 33 U.S. states plus Washington, DC, and Puerto Rico, making it one of the largest and most diverse studies of its kind.
The study compared results in several ways: between participants with and without prior SARS-CoV-2 infection at six months after infection, between participants with and without PASC, and between participants with each of the four most common PASC symptom phenotypes and those unlikely to have PASC.
Modest Differences, But No Clear Biomarkers
They found participants with prior SARS-CoV-2 infection showed modest increases in HbA1c (a marker of long-term blood sugar levels) and urinary albumin-to-creatinine ratio (uACR), along with small decreases in platelet counts.
"While these differences are statistically significant, these associations are generally small and not reliable enough to serve as diagnostic biomarkers for PASC," Erlandson says.
The researchers suggest this data shows the complexity of PASC as a condition that may involve multiple physiological pathways beyond simple laboratory markers, such as those for inflammation, anemia, or other markers.
"Long COVID has been very elusive; numerous possible symptoms, no definite cause, and no clear treatment. We hear from patients that their concerns are dismissed by providers because their lab tests are normal. In this study, even the exhaustive list of routine blood tests could not help in making a PASC diagnosis. This is an important observation in PASC research as prior smaller studies showed inconsistent abnormalities in some blood tests. Until a reliable biomarker is found, the best diagnostic modality for PASC remains the old-fashioned history taking and clinical assessment," Grace McComsey, MD, senior author of the paper, professor and vice dean of clinical and translational research at Case Western Reserve University.
The researchers also note that it's still important to do routine laboratory tests to rule out other conditions during the process of diagnosing PASC.
Reference: "Differentiation of Prior SARS-CoV-2 Infection and Postacute Sequelae by Standard Clinical Laboratory Measurements in the RECOVER Cohort" by Kristine M. Erlandson, Linda N. Geng, Caitlin A. Selvaggi, Tanayott Thaweethai, Peter Chen, Nathan B. Erdmann, Jason D. Goldman, Timothy J. Henrich, Mady Hornig, Elizabeth W. Karlson, Stuart D. Katz, C. Kim, Sushma K. Cribbs, Adeyinka O. Laiyemo, Rebecca Letts, Janet Y. Lin, Jai Marathe, Sairam Parthasarathy, Thomas F. Patterson, Brittany D. Taylor, Elizabeth R. Duffy, Monika Haack, Boris Julg, Gabrielle Maranga, Carla Hernandez, Nora G. Singer, Jenny Han, Priscilla Pemu, Hassan Brim, Hassan Ashktorab, Alexander W. Charney, Juan Wisnivesky, Jenny J. Lin, Helen Y. Chu, Minjoung Go, Upinder Singh, Emily B. Levitan, Paul A. Goepfert, Janko Ž. Nikolich, Harvey Hsu, Michael J. Peluso, J. Daniel Kelly, Megumi J. Okumura, Valerie J. Flaherman, John G. Quigley, Jerry A. Krishnan, Mary Beth Scholand, Rachel Hess, Torri D. Metz, Maged M. Costantine, Dwight J. Rouse, Barbara S. Taylor, Mark P. Goldberg, Gailen D. Marshall, Jeremy Wood, David Warren, Leora Horwitz, Andrea S. Foulkes and Grace A. McComsey, 13 August 2024, Annals of Internal Medicine.
DOI: 10.7326/M24-0737
News
Scientists Discover a Hidden “Immune Organ” Inside the Skull
Researchers discovered lymph node-like immune hubs inside skull bone marrow that appear to act as rapid-response centers for the brain. For decades, the brain was thought to operate largely apart from the immune system. [...]
Engineered tRNAs and lipid nanoparticles target nonsense mutation cystic fibrosis
Researchers have developed a potential new approach for treating a form of cystic fibrosis caused by so-called nonsense mutations, combining chemically modified transfer RNAs with lipid nanoparticles designed to deliver the therapy directly to [...]
New pancreatic cancer drug carries a $39,800 monthly list price
A groundbreaking treatment for one of the most common forms of pancreatic cancer has been approved in pill form by the FDA. Revolution Medicines’ oral tablet daraxonrasib, branded as Rasonque, reduced the risk of [...]
Researchers Have Discovered a New Way To Reduce Chronic Nerve Pain
A cancer-linked protein called BRAF may help drive chronic nerve pain, and existing cancer drugs targeting it reduced pain sensitivity in preclinical models. Chronic nerve pain can persist long after an injury and often [...]
Our books now available worldwide!
Online Sellers other than Amazon, Routledge, and IOPP Indigo Global Health Care Equivalency in the Age of Nanotechnology, Nanomedicine and Artifcial Intelligence Global Health Care Equivalency In The Age Of Nanotechnology, Nanomedicine And Artificial [...]
Quantum-Enabled Regenerative Health: Reimagining Wellness, Precision Health and Longevity Medicine
Introduction Healthcare is approaching a frontier where the quantum portfolio could influence not only how disease is diagnosed and treated, but how health itself is measured, modeled, predicted and preserved. Quantum computing, quantum simulation, [...]
FDA Clears First-of-Its-Kind Nonmedication Treatment for PTSD
The FDA has cleared a system that uses brain activity data to personalize magnetic stimulation for PTSD, adding a new nonmedication treatment option. Every day in the United States, approximately 17.5 veterans die by suicide, [...]
FDA approves breakthrough drug to treat advanced pancreatic cancer
The Food and Drug Administration (FDA) approved on Wednesday a drug that could extend the survival of those with metastatic pancreatic cancer. The drug, called daraxonrasib, will be sold under the brand name Rasonque [...]
AI Decodes a Hidden DNA Signal Linked to Disease-Causing Mutations
Machine learning identifies the likely “initiator” and enables new predictions about DNA mutations that can cause disease. Every human cell depends on tens of thousands of genes being switched on at the right time [...]
Pope Leo Urges Global Response to Congo’s Deadliest Ebola Outbreak
Pope Leo called for international action to address the Ebola outbreak in the Democratic Republic of Congo. The epidemic has claimed over 2,500 lives and is the nation's largest recorded outbreak. The Pope emphasized [...]
Is there a summer COVID-19 surge this year? Yep, it’s ramping up again
Hantavirus. Ebola. West Nile. Measles. And, of course, cyclospora — that stomach parasite making people miserable across the country. Americans have plenty to worry about this summer. But remember COVID-19? It may not be [...]
Natural Compound in Broccoli Could Help Treat a Rare, Incurable Neurological Disease
Swinburne researchers have discovered how broccoli could help treat an extremely rare and incurable disease that affects only about 200 Australians. A naturally occurring compound in broccoli is being investigated as a possible treatment [...]
Antibody recycling, FcRn and the next generation of biologics
FcRn plays a central role in regulating the half-life of IgG antibodies and albumin, making it a critical target in both antibody engineering and autoimmune disease therapy. This article explores the biology of FcRn, [...]
Ebola kills 2,300 in three months with no vaccine available for Congo’s deadliest ever outbreak
It’s Congo’s 17th outbreak, with a toll that has eclipsed that of the country’s 2018-2020 outbreak when 2,299 deaths out of 3,481 cases were recorded. The latest data shows 101 new cases and 33 [...]
Beyond an Agency: How AI, Creativity and Commercialization Are Converging Into a New Growth Model
At a moment when AI is forcing a fundamental rethink of how work gets done, the life sciences industry is grappling with a deeper question: what role should human creativity play in an increasingly [...]
New $60 Blood Test Detects Lung Cancer Without Costly DNA Sequencing
A simple blood test that detects chemical changes in DNA identified more than 90% of stage 2-4 lung cancers in an early study, without relying on costly DNA sequencing. Researchers at Tel Aviv University and collaborating [...]
