{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:23:26Z","timestamp":1789071806896,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:00:00Z","timestamp":1751068800000},"content-version":"vor","delay-in-days":178,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["K23 GM120630"],"award-info":[{"award-number":["K23 GM120630"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Immunology Research"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    Characterization of immune system heterogeneity in COVID\u201019 patients by comparing the inflammatory markers heparin\u2010binding protein (HBP), serum amyloid A protein (SAA), IL\u20106, and C\u2010reactive protein (CRP) in relation to viral burden, immune response, and tissue damage. Also, determine if prolonged elevations in these markers are associated with long\u2010term symptoms of COVID\u201019.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This study enrolled 106 hospitalized patients with PCR\u2010confirmed diagnoses of COVID\u201019. Blood samples were collected within 24\u2009h of admission (\n                    <jats:italic>t<\/jats:italic>\n                    <jats:sub>24h<\/jats:sub>\n                    ), at 48\u2009h (\n                    <jats:italic>t<\/jats:italic>\n                    <jats:sub>48h<\/jats:sub>\n                    ), 7 days (\n                    <jats:italic>t<\/jats:italic>\n                    <jats:sub>7d<\/jats:sub>\n                    ), and long\u2010term, greater than 1 month, post discharge (\n                    <jats:italic>t<\/jats:italic>\n                    <jats:sub>LongTerm<\/jats:sub>\n                    ). Serum levels of HBP, SAA, IL\u20106, and CRP were measured using a commercial point\u2010of\u2010care device. Viral burden was assessed via serum viral spike S\u2010protein serum levels and specific immunoglobulins G, M, and D against S&amp;N proteins, and SARS\u2010CoV\u20102 proteins were quantified. Tissue injury was evaluated by measuring HMGB\u20101 levels. Clinical data were reviewed retrospectively. Healthy individual samples served as controls.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    COVID\u201019 patients exhibited significantly elevated serum HBP and SAA compared to healthy controls. SAA levels normalized over 1 month, whereas HBP, CRP, and IL\u20106 remained persistently elevated. Patients requiring intensive care unit (ICU) admission, endotracheal intubation, or extracorporeal membrane oxygen (ECMO) demonstrated higher CRP, IL\u20106, and HBP at initial assessment. However, after 48\u2009h, only IL\u20106 was elevated in patients who subsequently expired. No significant correlations emerged between serum HBP levels and HMGB\u20101, viral spike protein levels, or antibodies against SARS\u2010CoV\u20102 proteins. Pre\u2010existing or acquired comorbidities did not significantly influence HBP or SAA concentrations. An analysis of biomarker profiles identified four distinct patient clusters, each characterized by unique inflammatory patterns that remained stable over time. Specifically, Cluster 1 exhibited low IL\u20106 with high SAA and CRP. Cluster 2 had low HBP with the highest IL\u20106. Cluster 3 demonstrated low SAA and CRP levels, and Cluster 4 exhibited robust inflammatory responses across all markers except IL\u20106.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    The persistence of inflammatory markers suggests ongoing inflammatory responses post\u2010COVID\u201019 infection. Significant heterogeneity observed in inflammatory responses upon admission indicates multiple distinct inflammatory phenotypes, which may have implications for clinical outcomes and management strategies.\n                  <\/jats:p>","DOI":"10.1155\/jimr\/8881752","type":"journal-article","created":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T04:34:24Z","timestamp":1751085264000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Longitudinal Analysis of Traditional Inflammatory Markers (IL\u20106, CRP) Juxtaposed With Heparin\u2010Binding Protein (HBP) and Serum Amyloid A Protein Component (SAA) During Acute Infection and Convalescence From COVID\u201019 Infection in the Context of Initial Viral Load and Markers of Tissue Destruction"],"prefix":"10.1155","volume":"2025","author":[{"given":"Ahmed 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