Preprint Symptoms and Pathophysiology of Post-Acute Sequelae of SARS-CoV-2 (PASC): A Cohort Study, 2024, Robineau et al

Symptoms and Pathophysiology of Post-Acute Sequelae of SARS-CoV-2 (PASC): A Cohort Study

Olivier Robineau, Sophie Hüe, Mathieu Surenaud, Cédric Lemogne, Céline Dorival, Emmanuel Wiernik, Sebastian Brami, Jerome Nicol, Xavier de Lamballerie, Hélène Blanché, Jean-François Deleuze, Céline Ribet, Marcel Goldberg, Gianluca Severi, Mathilde Touvier, Marie Zins, Yves Levy, Jean-Daniel Lelievre, Fabrice Carrat

[Preprint]

Background: Several studies reported long-term consequences of severe COVID-19. However, pathophysiological mechanisms of Post-Acute Sequelae following COVID-19 (PASC) in patients with mild acute COVID-19 have been less investigated. Specifically, the link between PASC and immuno-inflammatory abnormalities is inconsistent in the literature. The hypothesis that different pathophysiological mechanisms could explain the persistent symptoms needs to be explored.

Methods: The COPER cohort is a prospective study that included participants with PASC and with a history of COVID-19 without persistent symptoms. None were hospitalized for COVID-19. Participants underwent two home visits six months apart for biological sample collection and completed questionnaires on medical history, infection, vaccination, symptoms, and mental health. The study analyzed association between persistent symptoms and 14 blood biomarkers, comparing participants with PASC with recovered participants.

Findings: Between June and November 2022, 1000 participants were included in the study, 199 were excluded due to missing data or sample (35), SARS-CoV-2 infection less than 3 months (36) or lack of known SARS-CoV-2 infection and negative serology (128), with two groups analyzed: recovered (n=490), PASC (n=311). Participants with PASC were more frequently women, had a higher BMI and a median number of 3 persistent symptoms, with common symptoms being asthenia, dyspnea, cough, and sleep disorders. Biological analysis revealed significant associations between certain PACS symptoms and biomarkers of viral activation (IFNγ, IP-10), COVID-19 severity (CD163, IL-8) and vascular activation (VCAM-1, ICAM-1), mainly in subjects whose symptoms had lasted less than a year. However, these associations did not persist over time.

Interpretation: The results suggest a polymorphic and dynamic pathophysiology according to symptoms and time from infection. Other hypotheses, beyond those related to persistent inflammation, should be explored.

Link | PDF (Preprint) [Open Access]

 

This is really cool as a way to include more severe people.

It seems at this point long COVID research may be giving us clues into that stage (1st year or two) when you are developing ME/CFS and a lot of people spontaneously recover.