Nature Communications (Jan 2024)
Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study
- 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,
- Albert C. Shaw,
- Hady Samaha,
- Vicki Seyfert-Margolis,
- Florian Krammer,
- Lindsey B. Rosen,
- Hanno Steen,
- Caitlin Syphurs,
- Ravi Dandekar,
- Casey P. Shannon,
- Rafick P. Sekaly,
- Lauren I. R. Ehrlich,
- David B. Corry,
- Farrah Kheradmand,
- Mark A. Atkinson,
- Scott C. Brakenridge,
- Nelson I. Agudelo Higuita,
- Jordan P. Metcalf,
- Catherine L. Hough,
- William B. Messer,
- Bali Pulendran,
- Kari C. Nadeau,
- Mark M. Davis,
- Ana Fernandez Sesma,
- Viviana Simon,
- Harm van Bakel,
- Seunghee Kim-Schulze,
- David A. Hafler,
- Ofer Levy,
- Monica Kraft,
- Chris Bime,
- Elias K. Haddad,
- Carolyn S. Calfee,
- David J. Erle,
- Charles R. Langelier,
- Walter Eckalbar,
- Steven E. Bosinger,
- IMPACC Network,
- Bjoern Peters,
- Steven H. Kleinstein,
- Elaine F. Reed,
- Alison D. Augustine,
- Joann Diray-Arce,
- Holden T. Maecker,
- Matthew C. Altman,
- Ruth R. Montgomery,
- Patrice M. Becker,
- Nadine Rouphael
Affiliations
- Al Ozonoff
- Clinical & Data Coordinating Center (CDCC), Precision Vaccines Program, Boston Children’s Hospital
- Naresh Doni Jayavelu
- Benaroya Research Institute
- Shanshan Liu
- Clinical & Data Coordinating Center (CDCC), Precision Vaccines Program, Boston Children’s Hospital
- Esther Melamed
- The University of Texas at Austin
- Carly E. Milliren
- Clinical & Data Coordinating Center (CDCC), Precision Vaccines Program, 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 Clinical Site: Precision Vaccines Program, 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 Clinical Site: Precision Vaccines Program, Boston Children’s Hospital, Brigham and Women’s Hospital, and Harvard Medical School
- Caitlin Syphurs
- Clinical & Data Coordinating Center (CDCC), Precision Vaccines Program, Boston Children’s Hospital
- Ravi Dandekar
- University of California San Francisco School of Medicine
- Casey P. Shannon
- Centre for Heart Lung Innovation, Providence Research, 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 Clinical Site: Precision Vaccines Program, 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
- IMPACC Network
- 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
- Clinical & Data Coordinating Center (CDCC), Precision Vaccines Program, 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
- DOI
- https://doi.org/10.1038/s41467-023-44090-5
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 17
Abstract
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.
