Early biological markers of post-acute sequelae of SARS-CoV-2 infection
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.
Authors
- Raul Andino (ORCID: https://orcid.org/0000-0001-5503-9349)
- Jeffrey N. Martin (ORCID: https://orcid.org/0000-0002-9773-3256)
- Kevin C. Donohue (ORCID: https://orcid.org/0000-0002-4237-5957)
- Badri Viswanathan (ORCID: https://orcid.org/0009-0001-4779-5037)
- David V. Glidden (ORCID: https://orcid.org/0000-0001-5888-1419)
- Sharon Saydah (ORCID: https://orcid.org/0000-0002-6350-5300)
- Amethyst Zhang
- John Winslow (ORCID: https://orcid.org/0000-0003-2701-2493)
- Ahmed Chenna (ORCID: https://orcid.org/0000-0001-6201-2494)
- Claire M. Midgley (ORCID: https://orcid.org/0000-0001-5196-4713)
- Sarah A. Goldberg (ORCID: https://orcid.org/0000-0002-8642-1468)
- Rebecca Hoh (ORCID: https://orcid.org/0000-0001-5112-4220)
- Kara Lugtu
- Jessica Y. Chen (ORCID: https://orcid.org/0000-0002-4491-2584)
- Michelle C. Davidson (ORCID: https://orcid.org/0000-0002-5518-9774)
- Miguel Garcia-Knight (ORCID: https://orcid.org/0000-0001-9556-3719)
- Christos J. Petropoulos (ORCID: https://orcid.org/0000-0001-5496-8090)
- Ana María Salinas‐Martínez (ORCID: https://orcid.org/0000-0001-9977-4193)
- Michael J. Peluso (ORCID: https://orcid.org/0000-0003-0585-6230)
- Jesus Pineda-Ramirez
- Melissa Briggs‐Hagen
- Khamal Anglin (ORCID: https://orcid.org/0000-0002-1801-5345)
- David R. McIlwain (ORCID: https://orcid.org/0000-0002-2537-0273)
- Steven G. Deeks (ORCID: https://orcid.org/0000-0001-6371-747X)
- Sara Park (ORCID: https://orcid.org/0000-0001-9584-5003)
- John Daniel Kelly (ORCID: https://orcid.org/0000-0002-7616-0321)
- M. So (ORCID: https://orcid.org/0009-0006-4446-8600)
- Brandon C. Yee (ORCID: https://orcid.org/0000-0003-4649-7975)
- Michel Tassetto (ORCID: https://orcid.org/0000-0001-5666-8796)
- Scott Lu
- Maya Fortes-Cobby
- Brice Gaudiliere
- Aidan Donovan
Institutions
- University of California, San Francisco (US)
- LabCorp (United States) (US)
- San Francisco Foundation (US)
- Stanford Medicine (US)
- Global Brain Health Institute (US)
- Universidad Nacional Autónoma de México (MX)
Publication Details
- Journal
- Nature Communications
- Published
- 2024-08-29
- DOI
- https://doi.org/10.1038/s41467-024-51893-7
- Citations
- 37
- Primary Topic
- Long-Term Effects of COVID-19
- Type
- article
- Field-Weighted Citation Impact
- 13.66
Funders
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute of Allergy and Infectious Diseases