Anti-nucleocapsid antibody levels and pulmonary comorbid conditions are linked to post-COVID-19 syndrome
Xiaolin Jia, Shu Cao, Alexandra S Lee, Monali Manohar, Sayantani B Sindher, Neera Ahuja, Maja Artandi, Catherine A Blish, Andra L Blomkalns, Iris Chang, William J Collins, Manisha Desai, Hena Naz Din, Evan Do, Andrea Fernandes, Linda N Geng, Yael Rosenberg-Hasson, Megan Ruth Mahoney, Abigail L Glascock, Lienna Y Chan, Sharon Y Fong, CLIAHUB Consortium, Chan Zuckerberg Biohub, Maira Phelps, Olivia Raeber, Stanford COVID-19 Biobank Study Group, Natasha Purington, Katharina Röltgen, Angela J Rogers, Theo Snow, Taia T Wang, Daniel Solis, Laura Vaughan, Michelle Verghese, Holden Maecker, Richard Wittman, Rajan Puri, Amy Kistler, Samuel Yang, Scott D Boyd, Benjamin A Pinsky, Sharon Chinthrajah, Kari C Nadeau, Xiaolin Jia, Shu Cao, Alexandra S Lee, Monali Manohar, Sayantani B Sindher, Neera Ahuja, Maja Artandi, Catherine A Blish, Andra L Blomkalns, Iris Chang, William J Collins, Manisha Desai, Hena Naz Din, Evan Do, Andrea Fernandes, Linda N Geng, Yael Rosenberg-Hasson, Megan Ruth Mahoney, Abigail L Glascock, Lienna Y Chan, Sharon Y Fong, CLIAHUB Consortium, Chan Zuckerberg Biohub, Maira Phelps, Olivia Raeber, Stanford COVID-19 Biobank Study Group, Natasha Purington, Katharina Röltgen, Angela J Rogers, Theo Snow, Taia T Wang, Daniel Solis, Laura Vaughan, Michelle Verghese, Holden Maecker, Richard Wittman, Rajan Puri, Amy Kistler, Samuel Yang, Scott D Boyd, Benjamin A Pinsky, Sharon Chinthrajah, Kari C Nadeau
Abstract
BACKGROUNDProlonged symptoms after SARS-CoV-2 infection are well documented. However, which factors influence development of long-term symptoms, how symptoms vary across ethnic groups, and whether long-term symptoms correlate with biomarkers are points that remain elusive.METHODSAdult SARS-CoV-2 reverse transcription PCR-positive (RT-PCR-positive) patients were recruited at Stanford from March 2020 to February 2021. Study participants were seen for in-person visits at diagnosis and every 1-3 months for up to 1 year after diagnosis; they completed symptom surveys and underwent blood draws and nasal swab collections at each visit.RESULTSOur cohort (n = 617) ranged from asymptomatic to critical COVID-19 infections. In total, 40% of participants reported at least 1 symptom associated with COVID-19 six months after diagnosis. Median time from diagnosis to first resolution of all symptoms was 44 days; median time from diagnosis to sustained symptom resolution with no recurring symptoms for 1 month or longer was 214 days. Anti-nucleocapsid IgG level in the first week after positive RT-PCR test and history of lung disease were associated with time to sustained symptom resolution. COVID-19 disease severity, ethnicity, age, sex, and remdesivir use did not affect time to sustained symptom resolution.CONCLUSIONWe found that all disease severities had a similar risk of developing post-COVID-19 syndrome in an ethnically diverse population. Comorbid lung disease and lower levels of initial IgG response to SARS-CoV-2 nucleocapsid antigen were associated with longer symptom duration.TRIAL REGISTRATIONClinicalTrials.gov, NCT04373148.FUNDINGNIH UL1TR003142 CTSA grant, NIH U54CA260517 grant, NIEHS R21 ES03304901, Sean N Parker Center for Allergy and Asthma Research at Stanford University, Chan Zuckerberg Biohub, Chan Zuckerberg Initiative, Sunshine Foundation, Crown Foundation, and Parker Foundation.
Keywords: Immunoglobulins; Infectious disease.
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Source: PubMed