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Journal Article Systematic Review Epublish 3 citations

PubMed: 39435694 DOI: 10.1017/erm.2024.32

Epigenetic changes in patients with post-acute COVID-19 symptoms (PACS) and long-COVID: A systematic review.

Expert Rev Mol Med 26:e29

Authors: Madhura Shekhar Patil, Emma Richter, Lara Fanning, Jolien Hendrix, Arne Wyns, Laura Barrero Santiago, Jo Nijs, Lode Godderis, Andrea Polli

Affiliations

  • Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
  • Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology, and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
  • Research Foundation, Flanders (FWO).
  • Department of Cell Biology, Genetics, Pharmacology and Histology - University of Valladolid, Spain.
  • Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
  • External Service for Prevention and Protection at Work (IDEWE), Leuven, Belgium.

Abstract

BACKGROUND

Up to 30% of people infected with SARS-CoV-2 report disabling symptoms 2 years after the infection. Over 100 persistent symptoms have been associated with Post-Acute COVID-19 Symptoms (PACS) and/or long-COVID, showing a significant clinical heterogeneity. To develop effective, patient-targeted treatment, a better understanding of underlying mechanisms is needed. Epigenetics has helped elucidating the pathophysiology of several health conditions and it might help unravelling inter-individual differences in patients with PACS and long-COVID. As accumulating research is exploring epigenetic mechanisms in PACS and long-COVID, we systematically summarized the available literature on the topic.

METHODS

We interrogated five databases (Medline, Embase, Web of Science, Scopus and medXriv/bioXriv) and followed PRISMA and SWiM guidelines to report our results.

RESULTS

Eight studies were included in our review. Six studies explored DNA methylation in PACS and/or long-COVID, while two studies explored miRNA expression in long-COVID associated with lung complications. Sample sizes were mostly small and study quality was low or fair. The main limitation of the included studies was a poor characterization of the patient population that made a homogeneous synthesis of the literature challenging. However, studies on DNA methylation showed that mechanisms related to the immune and the autonomic nervous system, and cell metabolism might be implicated in the pathophysiology of PACS and long-COVID.

CONCLUSION

Epigenetic changes might help elucidating PACS and long-COVID underlying mechanisms, aid subgrouping, and point towards tailored treatments. Preliminary evidence is promising but scarce. Biological and epigenetic research on long-COVID will benefit millions of people suffering from long-COVID and has the potential to be transferable and benefit other conditions as well, such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). We urge future research to employ longitudinal designs and provide a better characterization of included patients.

MeSH

Molecular Biology, Fatigue Syndrome, Chronic, Signs And Symptoms, Covid-19, Research, Therapeutics, Post-Acute Covid-19 Syndrome

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