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Horm Metab Res 2024; 56(04): 318-323
DOI: 10.1055/a-2186-8108
Original Article: Endocrine Care

Long-COVID is Associated with Impaired Red Blood Cell Function

Romy Kronstein-Wiedemann  ‡
1   Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
2   German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
,
Kristin Tausche‡
3   Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany
,
Martin Kolditz
3   Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany
,
Madeleine Teichert
2   German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
,
Jessica Thiel
1   Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
,
Dirk Koschel
3   Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany
4   Department of Internal Medicine and Pneumology, Fachkrankenhaus Coswig, Lung Center, Coswig, Germany
,
Torsten Tonn
1   Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
2   German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
,
Stephan R. Künzel
1   Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
2   German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
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Abstract

COVID-19 disease, caused by the severe acute respiratory syndrome virus 2 (SARS-CoV-2), induces a broad spectrum of clinical symptoms ranging from asymptomatic cases to fatal outcomes. About 10–35% of all COVID-19 patients, even those with mild COVID-19 symptoms, continue to show symptoms, i. e., fatigue, shortness of breath, cough, and cognitive dysfunction, after initial recovery. Previously, we and others identified red blood cell precursors as a direct target of SARS-CoV-2 and suggested that SARS-CoV-2 induces dysregulation in hemoglobin- and iron-metabolism contributing to the severe systemic course of COVID-19. Here, we put particular emphasis on differences in parameters of clinical blood gas analysis and hematological parameters of more than 20 healthy and Long-COVID patients, respectively. Long-COVID patients showed impaired oxygen binding to hemoglobin with concomitant increase in carbon monoxide binding. Hand in hand with decreased plasma iron concentration and transferrin saturation, mean corpuscular hemoglobin was elevated in Long-COVID patients compared to healthy donors suggesting a potential compensatory mechanism. Although blood pH was within the physiological range in both groups, base excess- and bicarbonate values were significantly lower in Long-COVID patients. Furthermore, Long-COVID patients displayed reduced lymphocyte levels. The clinical relevance of these findings, e. g., as a cause of chronic immunodeficiency, remains to be investigated in future studies. In conclusion, our data suggest impaired erythrocyte functionality in Long-COVID patients, leading to diminished oxygen supply. This in turn could be an explanation for the CFS, dyspnea and anemia. Further investigations are necessary to identify the underlying pathomechanisms.

Key words

long-COVID - oxygen binding - COHb


Publication History

Received: 15 August 2023

Accepted after revision: 29 September 2023

Article published online:
27 October 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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