Biomarkers that can predict Long Covid in adolescents. This is the discovery made by a study by the CNR-Ibbc of Naples which indicates them, new and precocious, in young people who have fallen ill. The research, published on Diagnosticsopens up new fields of investigation in the field of long-term biological and psychological effects.
It is now established that in a percentage of those recovered from Covid a condition of malaise remains: symptoms related to the contracted virus, such as asthenia, fatigue, difficult breathing. But also cognitive symptoms, such as memory loss, difficulty concentrating, anxiety and depression, referred to as “brain fog”, at the basis of the clinical picture called NeuroCovid.
The Italian study
The recent pilot study coordinated by Marco Fiore e Carla Petrella of the Institute of Biochemistry and Cell Biology of the National Research Council of Rome (Cnr-Ibbc), which led, in fact, to the identification of early biomarkers of long-Covid in adolescents. The research was conducted at the Policlinico Umberto I of the Sapienza University, in collaboration with Raffaella Nenna, Fabio Midulla, Luigi Tarani of the Maternal Child and Urological Sciences Department e Antonio Minniof the Sense Organs Department.
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Measure biomarker levels
“We measured the levels of some inflammatory biomarkers and two neurotrophins (Ngf and Bdnf) – protein factors that regulate the growth, survival and morphology of neurons – in the serum of a small cohort of boys and girls who had contracted the infection. during the second wave of the pandemic, between September and October 2020, but negative at the time of collection – explained Fiore -. The young people were divided into three groups: asymptomatic, acute symptomatic, acute symptomatic that over time have developed long-Covid symptoms . And these data were then compared with the values that emerged from a sample group that had not contracted the disease “.
Inverse relationship between neurotrophins and stress syndromes
“As a result of all this we found that serum levels of Ngf were lower in all adolescents who had contracted Sars-Cov-2 infection, compared to healthy controls – underlined the coordinator of the pilot study -. The inverse relationship between levels of Ngf and stress syndromes is widely reported in the scientific literature “.
The research hypothesizes that the decrease in Ngf reflects a persistent activation of the stress axis, due to a direct effect of the virus or to the psycho-social effects resulting from isolation and changes in the daily routine encountered during quarantine periods.
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Higher biomarker levels in patients
“The levels of Bdnf – noted Petrella – similarly to the inflammatory biomarker Tgf, were instead higher in individuals who had fallen ill than in healthy ones, but only in symptomatic girls who then would have developed long-Covid-19 symptoms. In particular, the persistent increase in serum levels of Bdnf and Tgf was present in adolescents who presented respiratory symptoms during the acute phase of the infection “.
The studies will need to be deepened, broadening the research to a larger cohort of adolescents. “The data – concluded Fiore – however already support the hypothesis that the serum variations of Ngf and Bdnf represent an alarm bell for the long-term effect of Covid, opening new fields of investigation both in the field of physical effects and in the psychological ones potentially associated with Neuro Covid.
The effects of the virus
To outline the picture that, from the effects of the virus led to the new discovery of the Roman team, is Giovanni Magavirologist, director of the Cnr of Pavia.
“It is a proven fact that a very large number of people who have contracted the Covid disease then experience neurological, cardiological and respiratory consequences even for months or even years after recovery – explains Maga -. The causes are attributable to the deleterious effects that the virus, by replicating itself, has on the sick organism, in particular due to its ability to induce acute and persistent inflammation. However, the exact mechanisms underlying the post-Covid syndrome or Long Covid as it is defined are not yet clarified “. Furthermore, most of the available data refer to the adult population, but Long Covid also affects children and adolescents.
Spotlight on teenagers
Maga continues: “The IBBC-CNR study, in collaboration with the Policlinico Umberto I in Rome, set itself the goal of verifying whether in adolescents suffering from Long Covid there were altered blood chemistry parameters that could be used as biomarkers to assess the risk of developing long-term consequences “. Then he moves on to the results: “Altered levels of two neurotropic factors, that is proteins capable of regulating the function of neurons and a proinflammatory cytokine, were detected in the population of adolescents who, following the infection, then had symptoms compatible with Long Covid “.
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The two limits
But the study, Maga points out, “as noted by the authors themselves, has two important limitations: the small number of children enrolled and the difficulty of discriminating between the effects directly attributable to the action of the virus and the indirect ones due, for example, to factors of stress resulting from the forced isolation to which the children had to undergo because they were positive “. In fact, the expert recalls, “the loss of normal social interactions in the pediatric and adolescent age has a strong psychological impact, which at a physiological level can be reflected in an alteration of the factors that regulate neurological functions”.
Guide parameters for physicians
Therefore, the authors themselves suggest, “these first data will be expanded by verifying them on more numerous patient cohorts and investigating in detail the mechanisms underlying these alterations”. However, Maga concludes, “the study is significant because for the first time it states that there may be measurable parameters from a simple blood sample, which act as predictive biomarkers of the risk in healed children of experiencing post Covid syndrome. And this could guide doctors, but also families, to immediately set up approaches aimed at mitigating these possible consequences “.