Persistent symptoms after COVID-19 are not associated with differential SARS-CoV-2 antibody or T cell immunity

Daniel M. Altmann (), Catherine J. Reynolds, George Joy, Ashley D. Otter, Joseph M. Gibbons, Corinna Pade, Leo Swadling, Mala K. Maini, Tim Brooks, Amanda Semper, Áine McKnight, Mahdad Noursadeghi, Charlotte Manisty, Thomas A. Treibel, James C. Moon and Rosemary J. Boyton ()
Additional contact information
Daniel M. Altmann: Imperial College London
Catherine J. Reynolds: Imperial College London
George Joy: Barts Health NHS Trust
Ashley D. Otter: UK Health Security Agency
Joseph M. Gibbons: Queen Mary University of London
Corinna Pade: Queen Mary University of London
Leo Swadling: University College London
Mala K. Maini: University College London
Tim Brooks: UK Health Security Agency
Amanda Semper: UK Health Security Agency
Áine McKnight: Queen Mary University of London
Mahdad Noursadeghi: University College London
Charlotte Manisty: Barts Health NHS Trust
Thomas A. Treibel: Barts Health NHS Trust
James C. Moon: Barts Health NHS Trust
Rosemary J. Boyton: Imperial College London

Nature Communications, 2023, vol. 14, issue 1, 1-9

Abstract: Abstract Among the unknowns in decoding the pathogenesis of SARS-CoV-2 persistent symptoms in Long Covid is whether there is a contributory role of abnormal immunity during acute infection. It has been proposed that Long Covid is a consequence of either an excessive or inadequate initial immune response. Here, we analyze SARS-CoV-2 humoral and cellular immunity in 86 healthcare workers with laboratory confirmed mild or asymptomatic SARS-CoV-2 infection during the first wave. Symptom questionnaires allow stratification into those with persistent symptoms and those without for comparison. During the period up to 18-weeks post-infection, we observe no difference in antibody responses to spike RBD or nucleoprotein, virus neutralization, or T cell responses. Also, there is no difference in the profile of antibody waning. Analysis at 1-year, after two vaccine doses, comparing those with persistent symptoms to those without, again shows similar SARS-CoV-2 immunity. Thus, quantitative differences in these measured parameters of SARS-CoV-2 adaptive immunity following mild or asymptomatic acute infection are unlikely to have contributed to Long Covid causality. ClinicalTrials.gov (NCT04318314).

Date: 2023
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DOI: 10.1038/s41467-023-40460-1

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