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

Published: 14 July 2023| Version 3 | DOI: 10.17632/f234tpmp4y.3
IMPACC Network


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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University of Florida, Drexel University, Benaroya Research Institute at Virginia Mason, University of California Los Angeles, Icahn School of Medicine at Mount Sinai, University of California San Francisco, Yale University, University of Texas at Austin, Harvard Medical School, University of Arizona, Oregon Health and Science University Foundation, Stanford University, Baylor College of Medicine, Boston Children's Hospital, University of Oklahoma Health Sciences Center, Emory University School of Medicine


Immunology, Infectious Disease, Bioinformatics, Systems Biology, Big Data, COVID-19


National Institute of Allergy and Infectious Diseases