tetano
Editor, Senior Moderator
J Korean Med Sci
. 2024 Sep 9;39(35):e237.
doi: 10.3346/jkms.2024.39.e237. Viral, Immunologic, and Laboratory Parameters in Patients With and Without Post-Acute Sequelae of SARS-CoV-2 Infection (PASC)
Sang Hyun Ra[SUP] #[/SUP][SUP] 1 [/SUP], Euijin Chang[SUP] #[/SUP][SUP] 1 [/SUP], Ji-Soo Kwon[SUP] #[/SUP][SUP] 1 [/SUP], Ji Yeun Kim[SUP] 1 [/SUP], JuYeon Son[SUP] 1 [/SUP], Woori Kim[SUP] 1 [/SUP], Choi Young Jang[SUP] 1 [/SUP], Hyeon Mu Jang[SUP] 1 [/SUP], Seongman Bae[SUP] 1 [/SUP], Jiwon Jung[SUP] 1 [/SUP], Min Jae Kim[SUP] 1 [/SUP], Yong Pil Chong[SUP] 1 [/SUP], Sang-Oh Lee[SUP] 1 [/SUP], Sang-Ho Choi[SUP] 1 [/SUP], Yang Soo Kim[SUP] 1 [/SUP], Keun Hwa Lee[SUP] 2 [/SUP], Sung-Han Kim[SUP] 3 [/SUP]
Affiliations
Background: The pathophysiological mechanisms underlying the post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) are not well understood. Our study aimed to investigate various aspects of theses mechanisms, including viral persistence, immunological responses, and laboratory parameters in patients with and without PASC.
Methods: We prospectively enrolled adults aged ≥ 18 years diagnosed with coronavirus disease 2019 (COVID-19) between August 2022 and July 2023. Blood samples were collected at three time-points: within one month of diagnosis (acute phase) and at 1 month, and 3 months post-diagnosis. Following a recent well-designed definition of PASC, PASC patients were defined as those with a questionnaire-based PASC score ≥ 12 persisting for at least 4 weeks after the initial COVID-19 diagnosis.
Results: Of 57 eligible COVID-19 patients, 29 (51%) had PASC, and 28 (49%) did not. The PASC group had significantly higher nucleocapsid protein (NP) antigenemia 3 months after COVID-19 diagnosis (P = 0.022). Furthermore, several cytokines, including IL-2, IL-17A, VEGF, RANTES, sCD40L, IP-10, I-TAC, and granzyme A, were markedly elevated in the PASC group 1 and/or 3 month(s) after COVID-19 diagnosis. In contrast, the median values of several serological markers, including thyroid markers, autoimmune indicators, and stress-related hormones, were within the normal range.
Conclusion: Levels of NP antigen and of various cytokines involved in immune responses become significantly elevated over time after COVID-19 diagnosis in PASC patients compared to non-PASC patients. This suggests that PASC is associated with prolonged immune dysregulation resulting from heightened antigenic stimulation.
Keywords: COVID-19; Cytokine; Long-COVID; Nucleocapsid Protein (NP); Post-Acute Sequelae of SARS-CoV-2 Infection (PASC).
. 2024 Sep 9;39(35):e237.
doi: 10.3346/jkms.2024.39.e237. Viral, Immunologic, and Laboratory Parameters in Patients With and Without Post-Acute Sequelae of SARS-CoV-2 Infection (PASC)
Sang Hyun Ra[SUP] #[/SUP][SUP] 1 [/SUP], Euijin Chang[SUP] #[/SUP][SUP] 1 [/SUP], Ji-Soo Kwon[SUP] #[/SUP][SUP] 1 [/SUP], Ji Yeun Kim[SUP] 1 [/SUP], JuYeon Son[SUP] 1 [/SUP], Woori Kim[SUP] 1 [/SUP], Choi Young Jang[SUP] 1 [/SUP], Hyeon Mu Jang[SUP] 1 [/SUP], Seongman Bae[SUP] 1 [/SUP], Jiwon Jung[SUP] 1 [/SUP], Min Jae Kim[SUP] 1 [/SUP], Yong Pil Chong[SUP] 1 [/SUP], Sang-Oh Lee[SUP] 1 [/SUP], Sang-Ho Choi[SUP] 1 [/SUP], Yang Soo Kim[SUP] 1 [/SUP], Keun Hwa Lee[SUP] 2 [/SUP], Sung-Han Kim[SUP] 3 [/SUP]
Affiliations
- PMID: 39252682
- DOI: 10.3346/jkms.2024.39.e237
Background: The pathophysiological mechanisms underlying the post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) are not well understood. Our study aimed to investigate various aspects of theses mechanisms, including viral persistence, immunological responses, and laboratory parameters in patients with and without PASC.
Methods: We prospectively enrolled adults aged ≥ 18 years diagnosed with coronavirus disease 2019 (COVID-19) between August 2022 and July 2023. Blood samples were collected at three time-points: within one month of diagnosis (acute phase) and at 1 month, and 3 months post-diagnosis. Following a recent well-designed definition of PASC, PASC patients were defined as those with a questionnaire-based PASC score ≥ 12 persisting for at least 4 weeks after the initial COVID-19 diagnosis.
Results: Of 57 eligible COVID-19 patients, 29 (51%) had PASC, and 28 (49%) did not. The PASC group had significantly higher nucleocapsid protein (NP) antigenemia 3 months after COVID-19 diagnosis (P = 0.022). Furthermore, several cytokines, including IL-2, IL-17A, VEGF, RANTES, sCD40L, IP-10, I-TAC, and granzyme A, were markedly elevated in the PASC group 1 and/or 3 month(s) after COVID-19 diagnosis. In contrast, the median values of several serological markers, including thyroid markers, autoimmune indicators, and stress-related hormones, were within the normal range.
Conclusion: Levels of NP antigen and of various cytokines involved in immune responses become significantly elevated over time after COVID-19 diagnosis in PASC patients compared to non-PASC patients. This suggests that PASC is associated with prolonged immune dysregulation resulting from heightened antigenic stimulation.
Keywords: COVID-19; Cytokine; Long-COVID; Nucleocapsid Protein (NP); Post-Acute Sequelae of SARS-CoV-2 Infection (PASC).