Multiple early factors anticipate post-acute COVID-19 sequelae.
Document Type
Article
Publication Date
3-3-2022
Publication Title
Cell
Keywords
washington; seattle; isb; covid-19; Adaptive Immunity; Adolescent; Adult; Aged; Aged, 80 and over; Autoantibodies; Biomarkers; Blood Proteins; CD8-Positive T-Lymphocytes; COVID-19; Convalescence; Disease Progression; Female; Humans; Immunity, Innate; Longitudinal Studies; Male; Middle Aged; Risk Factors; SARS-CoV-2; Transcriptome; Young Adult
Abstract
Post-acute sequelae of COVID-19 (PASC) represent an emerging global crisis. However, quantifiable risk factors for PASC and their biological associations are poorly resolved. We executed a deep multi-omic, longitudinal investigation of 309 COVID-19 patients from initial diagnosis to convalescence (2-3 months later), integrated with clinical data and patient-reported symptoms. We resolved four PASC-anticipating risk factors at the time of initial COVID-19 diagnosis: type 2 diabetes, SARS-CoV-2 RNAemia, Epstein-Barr virus viremia, and specific auto-antibodies. In patients with gastrointestinal PASC, SARS-CoV-2-specific and CMV-specific CD8+ T cells exhibited unique dynamics during recovery from COVID-19. Analysis of symptom-associated immunological signatures revealed coordinated immunity polarization into four endotypes, exhibiting divergent acute severity and PASC. We find that immunological associations between PASC factors diminish over time, leading to distinct convalescent immune states. Detectability of most PASC factors at COVID-19 diagnosis emphasizes the importance of early disease measurements for understanding emergent chronic conditions and suggests PASC treatment strategies.
Department
Infectious Diseases
Department
Institute for Systems Biology
Department
Pathology & Laboratory Medicine
Recommended Citation
Su, Yapeng; Yuan, Dan; Chen, Daniel G; Ng, Rachel H; Wang, Kai; Choi, Jongchan; Li, Sarah; Hong, Sunga; Zhang, Rongyu; Xie, Jingyi; Kornilov, Sergey A; Scherler, Kelsey; Pavlovitch-Bedzyk, Ana Jimena; Dong, Shen; Lausted, Christopher; Lee, Inyoul; Fallen, Shannon; Dai, Chengzhen L; Baloni, Priyanka; Smith, Brett; Duvvuri, Venkata R; Anderson, Kristin G; Li, Jing; Yang, Fan; Duncombe, Caroline J; McCulloch, Denise J; Rostomily, Clifford; Troisch, Pamela; Zhou, Jing; Mackay, Sean; DeGottardi, Quinn; May, Damon H; Taniguchi, Ruth; Gittelman, Rachel M; Klinger, Mark; Snyder, Thomas M; Roper, Ryan; Wojciechowska, Gladys; Murray, Kim; Edmark, Rick; Evans, Simon; Jones, Lesley; Zhou, Yong; Rowen, Lee; Liu, Rachel; Chour, William; Algren, Heather A; Berrington, William R; Wallick, Julie A; Cochran, Rebecca A.; Micikas, Mary; ISB-Swedish COVID-19 Biobanking Unit; Wrin, Terri; Petropoulos, Christos J; Cole, Hunter R; Fischer, Trevan; Wei, Wei; Hoon, Dave; Price, Nathan D; Subramanian, Naeha; Hill, Joshua A; Hadlock, Jennifer J; Magis, Andrew T; Ribas, Antoni; Lanier, Lewis L; Boyd, Scott D; Bluestone, Jeffrey A; Chu, Helen; Hood, Leroy; Gottardo, Raphael; Greenberg, Philip D; Davis, Mark M; Goldman, Jason D; and Heath, James R, "Multiple early factors anticipate post-acute COVID-19 sequelae." (2022). Articles, Abstracts, and Reports. 5897.
https://digitalcommons.providence.org/publications/5897
