Early biological markers of post-acute sequelae of SARS-CoV-2 infection

Scott Lu, Michael J. Peluso, David V. Glidden, Michelle C. Davidson, Kara Lugtu, Jesus Pineda-Ramirez, Michel Tassetto, Miguel Garcia-Knight, Amethyst Zhang, Sarah A. Goldberg, Jessica Y. Chen, Maya Fortes-Cobby, Sara Park, Ana Martinez, Matthew So, Aidan Donovan, Badri Viswanathan, Rebecca Hoh, Kevin Donohue, David R. McIlwain, Brice Gaudiliere, Khamal Anglin, Brandon C. Yee, Ahmed Chenna, John W. Winslow, Christos J. Petropoulos, Steven G. Deeks, Melissa Briggs-Hagen, Raul Andino, Claire M. Midgley, Jeffrey N. Martin, Sharon Saydah and J. Daniel Kelly ()
Additional contact information
Scott Lu: San Francisco (UCSF)
Michael J. Peluso: UCSF
David V. Glidden: UCSF
Michelle C. Davidson: UCSF
Kara Lugtu: San Francisco (UCSF)
Jesus Pineda-Ramirez: San Francisco (UCSF)
Michel Tassetto: UCSF
Miguel Garcia-Knight: UCSF
Amethyst Zhang: UCSF
Sarah A. Goldberg: UCSF
Jessica Y. Chen: UCSF
Maya Fortes-Cobby: San Francisco (UCSF)
Sara Park: San Francisco (UCSF)
Ana Martinez: San Francisco (UCSF)
Matthew So: San Francisco (UCSF)
Aidan Donovan: UCSF
Badri Viswanathan: UCSF
Rebecca Hoh: UCSF
Kevin Donohue: UCSF
David R. McIlwain: Department of Microbiology and Immunology
Brice Gaudiliere: Department of Microbiology and Immunology
Khamal Anglin: San Francisco (UCSF)
Brandon C. Yee: South San Francisco
Ahmed Chenna: South San Francisco
John W. Winslow: South San Francisco
Christos J. Petropoulos: South San Francisco
Steven G. Deeks: UCSF
Melissa Briggs-Hagen: CDC
Raul Andino: UCSF
Claire M. Midgley: CDC
Jeffrey N. Martin: UCSF
Sharon Saydah: CDC
J. Daniel Kelly: San Francisco (UCSF)

Nature Communications, 2024, vol. 15, issue 1, 1-9

Abstract: Abstract To understand the roles of acute-phase viral dynamics and host immune responses in post-acute sequelae of SARS-CoV-2 infection (PASC), we enrolled 136 participants within 5 days of their first positive SARS-CoV-2 real-time PCR test. Participants self-collected up to 21 nasal specimens within the first 28 days post-symptom onset; interviewer-administered questionnaires and blood samples were collected at enrollment, days 9, 14, 21, 28, and month 4 and 8 post-symptom onset. Defining PASC as the presence of any COVID-associated symptom at their 4-month visit, we compared viral markers (quantity and duration of nasal viral RNA load, infectious viral load, and plasma N-antigen level) and host immune markers (IL-6, IL-10, TNF-α, IFN-α, IFN-γ, MCP, IP-10, and Spike IgG) over the acute period. Compared to those who fully recovered, those reporting PASC demonstrated significantly higher maximum levels of SARS-CoV-2 RNA and N-antigen, burden of RNA and infectious viral shedding, and lower Spike-specific IgG levels within 9 days post-illness onset. No significant differences were identified among a panel of host immune markers. Our results suggest early viral dynamics and the associated host immune responses play a role in the pathogenesis of PASC, highlighting the importance of understanding early biological markers in the natural history of PASC.

Date: 2024
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DOI: 10.1038/s41467-024-51893-7

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