Patient information

The burden and social impact of the long-term consequences of COVID-19 are enormous. Also known as long COVID, these long-term effects of COVID-19 have massive consequences on the personal health and even socioeconomic status of affected individuals. Our project surrounds the question of whether the analysis of a simple urine sample can predict long COVID.

Our research groups have already found out that severe (compared to moderate) disease progression can be predicted from urine. Using our prediction tool “urine peptidome classifier CoV50”, we previously analyzed protein fragments (peptides) in the urine at the beginning of the SARS-CoV-2 infection. The peptides in urine that were associated with severe COVID-19 included fragments of CD99, a protein that is involved in the formation of the intact endothelial barrier, where cells control the exchange of fluids and solutes at the border region to the lumen of blood and lymph vessels. [It can therefore be assumed that damage to small blood vessels, for example in the lungs, resulting in fluid accumulation (pulmonary edema) shows up in the urine in the form of CD99 fragments.]

In the project currently taking place, we are contacting COVID patients from our previous study “Crit-CoV-U” (Prospective Validation of a Proteomic Urine Test for Early and Accurate Prognosis of Critical Course Complications in Patients with SARS-CoV-2 Infection), to interview them and identify those with long COVID. Afterwards, we will be investigating whether the peptide (amino acid chain) pattern in the urine of these patients at the time of infection could be predictive of long COVID. Our goal is to identify a possible molecular mechanism for long COVID based on the long COVID-associated changes in urine.

Furthermore, we also try to work out the social aspects of long COVID and are therefore conducting a qualitative interview study. Since current, prominently published works suggest gender-specific inequality over the course of the pandemic (Flor et al., Lancet. 2022 Jun 25;399), we will analyze the experiences of men and women with long COVID. For this purpose, our interviews follow a given interview guide, are recorded on tape, anonymized, transcribed verbatim and thematically analyzed, for which the principles of “grounded theory” analysis from social science are applied. (Grounded theory means that a conceptual thematic theory is developed which is grounded on the data.)

Research groups from Germany, Sweden, Poland, Austria and France are involved in this project. We work with the 'University of Patients' in Paris as we wish to involve them throughout the research process by putting together a group of patient representatives. In doing so, we hope to ensure that their lived experience is truthfully acknowledged and transcribed in our study. Indeed, identifying long COVID is extremely challenging for healthcare professionals, because of the multisymptomatic aspect of the syndrome which can manifest in many ways. Therefore, long COVID patients struggle a lot with getting recognition for their suffering, because of the lack of a clear biomedical diagnosis. Our goal is to work towards finding a way that could help identifying people exposed to long COVID, as the alarming majority of them is left in a diagnostic odyssey today.

First research results underline that  younger patients (<65 years of age) have a significantly increased risk of death after surviving an acute COVID-19 infection. In addition, mortality can be predicted at an early stage by specific changes in peptide and protein markers in the urine (LINK).