Clinical, Inflammatory, and Serological Markers among Individuals with and without Post-COVID-19 Condition in Kenyatta University Community, Nairobi City County, Kenya
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Date
2025-11
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Kenyatta University
Abstract
Post-COVID-19 condition (PCC) is defined by persistent clinical manifestations after acute coronavirus disease 2019 (COVID-19). Approximately 10–20% of people across different populations are reported to have the condition. Inflammation is considered a key mechanism that drives the protracted disease. The titers of antibodies produced in response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are also reported to remain high in those with persisting COVID-19 symptoms. As an emerging disease, the clinical, inflammatory, and serological markers of PCC remain to be well-defined. In Kenya, patients’ reports of PCC have been captured in the local media, but scientific studies on this health conundrum are lacking. Biomarkers of inflammation, such as interleukin (IL)-6 and C-reactive protein (CRP), are upregulated in many cases of PCC and could be useful as diagnostic markers. This study aimed to determine the clinical, inflammatory, and serological markers among individuals with and without PCC in Kenyatta University community setting. The study employed an analytical cross-sectional design and was undertaken at the Directorate of Kenyatta University Health Services from April to July 2023. Purposive sampling approach was used to recruit the participants. A questionnaire was utilized to gather demographic and clinical data of the participants. Inflammatory and serological data were obtained from the participants’ serum through enzyme-linked immunosorbent assays (IL-6, Quantikine Human IL-6 Immunoassay; CRP, CRP ELISA kit; and anti-SARS-CoV-2 immunoglobulin G [IgG], Human SARS-CoV-2 Spike (Trimer) IgG ELISA). Relevant statistical tests in SPSS Version 18 (IBM Corp, Armonk, NY) were used to undertake data analysis. The t-test compared continuous variables, such as number of symptoms and levels of IL-6, CRP, and anti-SARS-CoV-2 IgG between the groups exhibiting and not exhibiting PCC symptoms. A p-value less than 0.05 was used as an indicator of statistical significance. Overall, 189 participants (female, 50.8%; mean age, 23.46 years) were enrolled. The prevalence of PCC was 30% (n=12), with six participants (50%) reporting persistent COVID-19 symptoms and seven participants (58.3%) reporting new-onset symptoms. The most reported persisting symptoms were cough (n=3, 33.3%), sore throat (n=2, 22.2%), and runny/stuffy nose (n=2, 22.2%), whereas the most common new symptoms included fatigue (n=3, 16.7%), loss of smell/taste (n=3, 16.7%), and joint pain (n=2, 11.1%). No significant differences in IL-6 (p-value = 0.90), CRP (p-value = 0.28), and anti-SARS-CoV-2 IgG (p-value = 0.08) were found between the individuals with and without PCC. The number and duration of COVID-19 manifestations were significantly higher in individuals with PCC than in those without the condition (p-values = 0.01 and 0.02, respectively). Based on these findings, it can be deduced that those who present with more COVID-19 symptoms and prolonged symptoms may be at a higher risk of PCC. It is recommended that public health surveillance for PCC in the general population be done to identify and sensitize those with the condition on how to manage it. Further research using well-designed prospective studies should be conducted to elucidate reliable biomarkers of PCC for better diagnosis and management.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Infectious Diseases) in the School of Health Sciences of Kenyatta University, November 2025.
Supervisors
1. Dr. Eric Ndombi
2. Dr Peris Thamaini