# Assessment of biochemical and hematological profiles in outpatients with serological evidence of SARS-CoV-2 infection

## TL;DR

This study found that even mild or asymptomatic SARS-CoV-2 infection can lead to subtle changes in cholesterol and liver enzymes in non-hospitalized adults.

## Contribution

The study identifies subclinical biochemical changes in ambulatory SARS-CoV-2 survivors, particularly in lipid and liver profiles.

## Key findings

- Seropositive individuals had significantly lower HDL-C levels compared to seronegatives.
- Seropositive individuals showed elevated AST and ALT levels, indicating potential liver enzyme changes.

## Abstract

SARS-CoV-2 infection is known to induce systemic biochemical and hematological alterations, particularly in hospitalized patients. However, data regarding subclinical changes in ambulatory, non-hospitalized individuals—especially in Latin American populations—remain limited.

To compare biochemical and hematological parameters between ambulatory adults with and without serological evidence of prior SARS-CoV-2 infection, in order to identify potential subclinical alterations associated with previous virus exposure.

A cross-sectional study was conducted in 201 ambulatory adults from central-northern Mexico between August and December 2020. Anti–SARS-CoV-2 IgG and IgM antibodies were detected using two independent lateral flow immunochromatographic assays. Participants were classified as seropositive only when both assays showed concordant reactivity. Biochemical and hematological parameters were compared between seropositive and seronegative individuals using appropriate parametric or non-parametric tests.

Overall seroprevalence of anti–SARS-CoV-2 antibodies was 22.3%. No significant differences were observed in hematological parameters between seropositive and seronegative participants. In contrast, seropositive individuals exhibited significantly lower high-density lipoprotein cholesterol (HDL-C) levels compared to seronegatives (median: 40.5 vs. 45.3 mg/dL; p = 0.009), with significance maintained in females. Liver enzymes were significantly higher among seropositive subjects, including aspartate aminotransferase (AST) (median: 30 vs. 24 U/L; p = 0.007) and alanine aminotransferase (ALT) (median: 32.5 vs. 20 U/L; p = 0.001). These differences were more pronounced in males. No significant differences were found in glucose, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), alkaline phosphatase (ALP), or total bilirubin (TB).

Even mild or asymptomatic SARS-CoV-2 infection is associated with subtle but consistent alterations in lipid metabolism and liver enzymes in ambulatory, unvaccinated individuals. These findings support the need for biochemical monitoring after SARS-CoV-2 infection, particularly in populations with high baseline cardiometabolic risk.