The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors

Abstract Background Persistent symptoms and complications reported by many patients for more than four weeks after contracting coronavirus disease 2019 (COVID-19) are referred to as post-COVID-19 syndrome. These persistent symptoms can occur in individuals with both mild and severe COVID-19, though...

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Main Authors: Elaheh Abiri, Ali Abiri, Salman Daneshi, Rasoul Raesi
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11419-y
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author Elaheh Abiri
Ali Abiri
Salman Daneshi
Rasoul Raesi
author_facet Elaheh Abiri
Ali Abiri
Salman Daneshi
Rasoul Raesi
author_sort Elaheh Abiri
collection DOAJ
description Abstract Background Persistent symptoms and complications reported by many patients for more than four weeks after contracting coronavirus disease 2019 (COVID-19) 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 non-intubated-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.
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spelling doaj-art-ca8a69af8e7d4257bdf78892813ac0f32025-08-24T11:09:57ZengBMCBMC Infectious Diseases1471-23342025-08-012511910.1186/s12879-025-11419-yThe silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivorsElaheh Abiri0Ali Abiri1Salman Daneshi2Rasoul Raesi3Department of Cellular and Molecular Biology, School of Biology, Institute of Biological Sciences, Damghan UniversityDepartment of Computer, Da.C., Islamic Azad UniversityDepartment of Public Health, School of Health, Jiroft University of Medical SciencesDepartment of Public Health, Torbat Jam Faculty of Medical Sciences, School of HealthAbstract Background Persistent symptoms and complications reported by many patients for more than four weeks after contracting coronavirus disease 2019 (COVID-19) 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 non-intubated-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.https://doi.org/10.1186/s12879-025-11419-yCOVID-19LymphopeniaComet assayDNA damagePost-COVID-19Long-term COVID-19
spellingShingle Elaheh Abiri
Ali Abiri
Salman Daneshi
Rasoul Raesi
The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors
BMC Infectious Diseases
COVID-19
Lymphopenia
Comet assay
DNA damage
Post-COVID-19
Long-term COVID-19
title The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors
title_full The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors
title_fullStr The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors
title_full_unstemmed The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors
title_short The silent legacy of COVID-19: exploring genomic instability in long-term COVID-19 survivors
title_sort silent legacy of covid 19 exploring genomic instability in long term covid 19 survivors
topic COVID-19
Lymphopenia
Comet assay
DNA damage
Post-COVID-19
Long-term COVID-19
url https://doi.org/10.1186/s12879-025-11419-y
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