Journal Article

Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study

Krammer, Florian, Dandekar, Ravi, Haddad, Elias K., Eckalbar, Walter, Kleinstein, Steven H., Rouphael, Nadine, Brakenridge, Scott C., Kraft, Monica, Melamed, Esther, Reed, Elaine F., McComsey, Grace A., Jayavelu, Naresh Doni, Rosen, Lindsey B., Levy, Ofer, Schaenman, Joanna, Hafler, David A., Altman, Matthew C., Peters, Bjoern, Atkinson, Mark A., Pulendran, Bali, Augustine, Alison D., Shannon, Casey P., Maecker, Holden T., Ehrlich, Lauren I. R., Montgomery, Ruth R., Sesma, Ana Fernandez, Samaha, Hady, Bosinger, Steven E., Erle, David J., Metcalf, Jordan P., Cairns, Charles B., Kheradmand, Farrah, Becker, Patrice M., Diray-Arce, Joann, Baden, Lindsey R., Ozonoff, Al, Higuita, Nelson I. Agudelo, Messer, William B., Shaw, Albert C., Milliren, Carly E., Geng, Linda N., Seyfert-Margolis, Vicki, Langelier, Charles R., Liu, Shanshan, van Bakel, Harm, Nadeau, Kari C., Simon, Viviana, Hough, Catherine L., Syphurs, Caitlin, Kim-Schulze, Seunghee, Steen, Hanno, Corry, David B., Sekaly, Rafick P., Calfee, Carolyn S., Bime, Chris, Qi, Jingjing, Davis, Mark M.

2024

Overview

Post-acute sequelae of SARS-CoV-2 (PASC) is a significant public health concern. We describe Patient Reported Outcomes (PROs) on 590 participants prospectively assessed from hospital admission for COVID-19 through one year after discharge. Modeling identified 4 PRO clusters based on reported deficits (minimal, physical, mental/cognitive, and multidomain), supporting heterogenous clinical presentations in PASC, with sub-phenotypes associated with female sex and distinctive comorbidities. During the acute phase of disease, a higher respiratory SARS-CoV-2 viral burden and lower Receptor Binding Domain and Spike antibody titers were associated with both the physical predominant and the multidomain deficit clusters. A lower frequency of circulating B lymphocytes by mass cytometry (CyTOF) was observed in the multidomain deficit cluster. Circulating fibroblast growth factor 21 (FGF21) was significantly elevated in the mental/cognitive predominant and the multidomain clusters. Future efforts to link PASC to acute anti-viral host responses may help to better target treatment and prevention of PASC. Post-acute sequelae of SARS-CoV-2 (PASC) is still not well understood. Here the authors provide patient reported outcomes from 590 hospitalized COVID-19 patients and show association of PASC with higher respiratory SARS-CoV-2 load and circulating antibody titers, and in some an elevation in circulating fibroblast growth factor 21.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 13/1 / 13/21 / 13/31 / 38/91 / 631/250 / 631/326/596/4130 / 692/699/255/2514 / Antibodies / Antiviral agents / Antiviral drugs / B-Lymphocytes / Body Fluids / Clinical outcomes / Clusters / Cognitive ability / Comorbidity / Complications / COVID-19 / COVID-19 - complications / Cytometry / Disease Progression / Female / Fibroblasts / Growth factors / Humanities and Social Sciences / Humans / Lymphocytes / Lymphocytes B / multidisciplinary / Patients / Phenotype / Phenotypes / Public health / SARS-CoV-2 / Science / Science (multidisciplinary) / Severe acute respiratory syndrome coronavirus 2 / Viral diseases