Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study, 2024, Ozonoff et al.

Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study
Ozonoff, Al; Jayavelu, Naresh Doni; Liu, Shanshan; Melamed, Esther; Milliren, Carly E.; Qi, Jingjing; Geng, Linda N.; McComsey, Grace A.; Cairns, Charles B.; Baden, Lindsey R.; Schaenman, Joanna; Shaw, Albert C.; Samaha, Hady; Seyfert-Margolis, Vicki; Krammer, Florian; Rosen, Lindsey B.; Steen, Hanno; Syphurs, Caitlin; Dandekar, Ravi; Shannon, Casey P.; Sekaly, Rafick P.; Ehrlich, Lauren I. R.; Corry, David B.; Kheradmand, Farrah; Atkinson, Mark A.; Brakenridge, Scott C.; Higuita, Nelson I. Agudelo; Metcalf, Jordan P.; Hough, Catherine L.; Messer, William B.; Pulendran, Bali; Nadeau, Kari C.; Davis, Mark M.; Sesma, Ana Fernandez; Simon, Viviana; van Bakel, Harm; Kim-Schulze, Seunghee; Hafler, David A.; Levy, Ofer; Kraft, Monica; Bime, Chris; Haddad, Elias K.; Calfee, Carolyn S.; Erle, David J.; Langelier, Charles R.; Eckalbar, Walter; Bosinger, Steven E.; Peters, Bjoern; Kleinstein, Steven H.; Reed, Elaine F.; Augustine, Alison D.; Diray-Arce, Joann; Maecker, Holden T.; Altman, Matthew C.; Montgomery, Ruth R.; Becker, Patrice M.; Rouphael, Nadine

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.

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[44] Are Circulating FGF21 and NT-proBNP promising novel biomarkers in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome? (2020, Antioxidants and Redox Signaling)