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Multiple early factors anticipate post-acute COVID-19 sequelae

2022; Cell Press; Volume: 185; Issue: 5 Linguagem: Inglês

10.1016/j.cell.2022.01.014

1097-4172

Yapeng Su, Dan Yuan, Daniel Chen, Raymond T. Ng, Kai Wang, Jongchan Choi, Sarah Li, Sunga Hong, Rongyu Zhang, Jingyi Xie, Sergey A. Kornilov, Kelsey Scherler, Ana Jimena Pavlovitch-Bedzyk, Shen Dong, Christopher Lausted, Inyoul Lee, Shannon Fallen, Chengzhen L. Dai, Priyanka Baloni, Brett Smith, Venkata R. Duvvuri, Kristin G. Anderson, Jing Li, Fan Yang, Caroline J. Duncombe, Denise J. McCulloch, Clifford Rostomily, Pamela Troisch, Jing Zhou, Sean Mackay, Quinn DeGottardi, Damon May, Ruth Taniguchi, Rachel Gittelman, Mark Klinger, Thomas M. Snyder, Ryan Roper, Gladys Wojciechowska, Kim M. Murray, Rick Edmark, Simon Evans, Lesley Jones, Yong Zhou, Lee Rowen, Rachel Liu, William Chour, Heather A. Algren, William R. Berrington, Julie A. Wallick, Rebecca A. Cochran, Mary Micikas, Terri Wrin, Christos J. Petropoulos, Hunter Cole, Trevan Fischer, Wei Wei, Dave S.�B. Hoon, Nathan D. Price, Naeha Subramanian, Joshua A. Hill, Jennifer Hadlock, Andrew T. Magis, Antoni Ribas, Lewis L. Lanier, Scott D. Boyd, Jeffrey A. Bluestone, Helen Y. Chu, Leroy Hood, Raphaël Gottardo, Philip D. Greenberg, Mark M. Davis, Jason D. Goldman, James R. Heath,

Tryptophan and brain disorders

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.