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Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study

Author

Listed:
  • Al Ozonoff

    (Boston Children’s Hospital)

  • Naresh Doni Jayavelu

    (Benaroya Research Institute)

  • Shanshan Liu

    (Boston Children’s Hospital)

  • Esther Melamed

    (The University of Texas at Austin)

  • Carly E. Milliren

    (Boston Children’s Hospital)

  • Jingjing Qi

    (Icahn School of Medicine at Mount Sinai)

  • Linda N. Geng

    (Stanford University)

  • Grace A. McComsey

    (Case Western Reserve University and University Hospitals of Cleveland)

  • Charles B. Cairns

    (Drexel University/Tower Health Hospital)

  • Lindsey R. Baden

    (Boston Children’s Hospital, Brigham and Women’s Hospital, and Harvard Medical School)

  • Joanna Schaenman

    (David Geffen School of Medicine at the University of California Los Angeles)

  • Albert C. Shaw

    (Yale School of Medicine, and Yale School of Public Health)

  • Hady Samaha

    (Emory University)

  • Vicki Seyfert-Margolis

    (MyOwnMed, Inc)

  • Florian Krammer

    (Icahn School of Medicine at Mount Sinai)

  • Lindsey B. Rosen

    (National Institute of Allergy and Infectious Diseases/National Institutes of Health)

  • Hanno Steen

    (Boston Children’s Hospital, Brigham and Women’s Hospital, and Harvard Medical School)

  • Caitlin Syphurs

    (Boston Children’s Hospital)

  • Ravi Dandekar

    (University of California San Francisco School of Medicine)

  • Casey P. Shannon

    (St. Paul’s Hospital, and the PROOF Centre of Excellence)

  • Rafick P. Sekaly

    (Case Western Reserve University and University Hospitals of Cleveland)

  • Lauren I. R. Ehrlich

    (The University of Texas at Austin)

  • David B. Corry

    (Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center)

  • Farrah Kheradmand

    (Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center)

  • Mark A. Atkinson

    (University of Florida/University of South Florida)

  • Scott C. Brakenridge

    (University of Florida/University of South Florida)

  • Nelson I. Agudelo Higuita

    (Oklahoma University Health Sciences Center)

  • Jordan P. Metcalf

    (Oklahoma University Health Sciences Center)

  • Catherine L. Hough

    (Oregon Health & Science University)

  • William B. Messer

    (Oregon Health & Science University)

  • Bali Pulendran

    (Stanford University)

  • Kari C. Nadeau

    (Stanford University)

  • Mark M. Davis

    (Stanford University)

  • Ana Fernandez Sesma

    (Icahn School of Medicine at Mount Sinai)

  • Viviana Simon

    (Icahn School of Medicine at Mount Sinai)

  • Harm van Bakel

    (Icahn School of Medicine at Mount Sinai)

  • Seunghee Kim-Schulze

    (Icahn School of Medicine at Mount Sinai)

  • David A. Hafler

    (Yale School of Medicine, and Yale School of Public Health)

  • Ofer Levy

    (Boston Children’s Hospital, Brigham and Women’s Hospital, and Harvard Medical School)

  • Monica Kraft

    (University of Arizona)

  • Chris Bime

    (University of Arizona)

  • Elias K. Haddad

    (Drexel University/Tower Health Hospital)

  • Carolyn S. Calfee

    (University of California San Francisco School of Medicine)

  • David J. Erle

    (University of California San Francisco School of Medicine)

  • Charles R. Langelier

    (University of California San Francisco School of Medicine)

  • Walter Eckalbar

    (University of California San Francisco School of Medicine)

  • Steven E. Bosinger

    (Emory University)

  • Bjoern Peters

    (La Jolla Institute for Immunology)

  • Steven H. Kleinstein

    (Yale School of Medicine, and Yale School of Public Health)

  • Elaine F. Reed

    (David Geffen School of Medicine at the University of California Los Angeles)

  • Alison D. Augustine

    (National Institute of Allergy and Infectious Diseases/National Institutes of Health)

  • Joann Diray-Arce

    (Boston Children’s Hospital)

  • Holden T. Maecker

    (Stanford University)

  • Matthew C. Altman

    (Benaroya Research Institute)

  • Ruth R. Montgomery

    (Yale School of Medicine, and Yale School of Public Health)

  • Patrice M. Becker

    (National Institute of Allergy and Infectious Diseases/National Institutes of Health)

  • Nadine Rouphael

    (Emory University)

Abstract

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.

Suggested Citation

  • Al Ozonoff & Naresh Doni Jayavelu & Shanshan Liu & Esther Melamed & Carly E. Milliren & Jingjing Qi & Linda N. Geng & Grace A. McComsey & Charles B. Cairns & Lindsey R. Baden & Joanna Schaenman & Albe, 2024. "Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study," Nature Communications, Nature, vol. 15(1), pages 1-17, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-023-44090-5
    DOI: 10.1038/s41467-023-44090-5
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