Features of acute COVID-19 associated with Post-Acute Sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study

Description

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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Institutions

• University of Florida

  FL, Gainesville
• Drexel University

  PA, Philadelphia
• Benaroya Research Institute at Virginia Mason

  WA, Seattle
• University of California Los Angeles

  CA, Los Angeles
• Icahn School of Medicine at Mount Sinai

  NY, New York
• University of California San Francisco

  CA, San Francisco
• Yale University

  CT, New Haven
• University of Texas at Austin

  TX, Austin
• Harvard Medical School

  MA, Boston
• University of Arizona

  AZ, Tucson
• Oregon Health and Science University Foundation

  OR, Portland
• Stanford University

  CA, Stanford
• Baylor College of Medicine

  TX, Houston
• Boston Children's Hospital

  MA, Boston
• University of Oklahoma Health Sciences Center

  OK, Oklahoma City
• Emory University School of Medicine

  GA, Atlanta

Categories

Funders

• National Institute of Allergy and Infectious Diseases

  Maryland, United States

  Grant ID: 5R01AI135803-03;5U19AI118608-04;5U19AI128910-04;4U19AI090023-11;4U19AI118610-06;R01AI145835-01A1S1;5U19AI062629-17;5U19AI057229-17;5U19AI125357-05;5U19AI128913-03;3U19AI077439-13;5U54AI142766-03;5R01AI104870-07;3U19AI089992-09;5R01AI132774-03

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