Markers of Immune Activation and Inflammation in Individuals With Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Author:

Peluso Michael J1ORCID,Lu Scott2,Tang Alex F1,Durstenfeld Matthew S3,Ho Hsi-en4,Goldberg Sarah A2,Forman Carrie A1,Munter Sadie E5,Hoh Rebecca1,Tai Viva1,Chenna Ahmed6,Yee Brandon C6,Winslow John W6,Petropoulos Christos J6,Greenhouse Bryan1,Hunt Peter W5,Hsue Priscilla Y3,Martin Jeffrey N2,Daniel Kelly J2,Glidden David V2ORCID,Deeks Steven G1,Henrich Timothy J5

Affiliation:

1. Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA

2. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA

3. Division of Cardiology, University of California, San Francisco, San Francisco, California, USA

4. Icahn School of Medicine at Mount Sinai, New York, New York, USA

5. Division of Experimental Medicine, University of California, San Francisco, San Francisco, California, USA

6. Monogram Biosciences Inc, South San Francisco, California, USA

Abstract

Abstract Background The biological processes associated with postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) are unknown. Methods We measured soluble markers of inflammation in a SARS-CoV-2 recovery cohort at early (<90 days) and late (>90 days) timepoints. We defined PASC as the presence of 1 or more coronavirus disease 2019 (COVID-19)–attributed symptoms beyond 90 days. We compared fold-changes in marker values between those with and without PASC using mixed-effects models with terms for PASC and early and late recovery time periods. Results During early recovery, those who went on to develop PASC generally had higher levels of cytokine biomarkers including tumor necrosis factor–α (1.14-fold higher mean ratio [95% confidence interval {CI}, 1.01–1.28]; P = .028) and interferon-γ–induced protein 10 (1.28-fold higher mean ratio [95% CI, 1.01–1.62]; P = .038). Among those with PASC, there was a trend toward higher interleukin 6 levels during early recovery (1.29-fold higher mean ratio [95% CI, .98–1.70]; P = .07), which became more pronounced in late recovery (1.44-fold higher mean ratio [95% CI, 1.11–1.86]; P < .001). These differences were more pronounced among those with a greater number of PASC symptoms. Conclusions Persistent immune activation may be associated with ongoing symptoms following COVID-19. Further characterization of these processes might identify therapeutic targets for those experiencing PASC.

Funder

National Institute of Allergy and Infectious Diseases

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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