HIGH LEVELS OF URINARY INFLAMMATORY MEDIATORS PRESENT IN POST COVID-19 CONDITION ARE RELATED TO ACUTE INFECTION SEVERITY

The Post COVID-19 Condition (PCC), was defined by the World Health Organization (WHO) as the persistence or emergence of new symptoms three months after SARS-CoV-2 infection. It is known that acute COVID-19 is associated with a hyperinflammatory status, especially in severe cases, and hospitalization is a predictor of disease severity. Besides, acute kidney injury is an important complication of COVID-19. Thus, we aimed to evaluate urinary cytokines, chemokines, and growth factors in patients with PCC. A cross-sectional study approved by the Ethics and Research Committee (CAAE 59213722.5.0000.5243) was performed with patients diagnosed with SARS-CoV-2 infection between 2020-2022. After interview, patients were classified with PCC according to the WHO criteria and the need for hospitalization in the acute phase of COVID-19. Laboratory data were obtained from medical records. The first morning urine was collected, centrifuged, and stored at -80°C. Urinary inflammatory mediators were measured using a multiplex assay (BioRad). The results were normalized by urinary creatinine. Of 78 participants, 56 (71.8%) were classified as PCC, with a mean age of 53 ± 14.6 years old. We identified that 18 (32%) PCC patients were previously hospitalized in acute phase. Regarding urinary inflammatory mediators, no significant differences were observed between patients with or without PCC. However, we observed increased levels of IL-4 (p=0.01), eotaxin (p=0.002), MCP-1 (p=0.02) and GM-CSF (p=0.04) in the PCC group who needed hospitalization during the acute phase. The same group also presented alterations in laboratory parameters such as elevated proteinuria (p=0.03), lactate dehydrogenase (p=0.01), prothrombin time (p=0.02), INR (p=0.02), and monocyte-to-lymphocyte ratio (p=0.03). Our results suggest that the increased levels of urinary inflammatory mediators in PCC might be related to a residual inflammatory status in patients who had moderate to severe COVID-19.