e-Article
Anti-nucleocapsid antibody levels and pulmonary comorbid conditions are linked to post–COVID-19 syndrome
Document Type
article
Author
Jia, Xiaolin; Cao, Shu; Lee, Alexandra S; Manohar, Monali; Sindher, Sayantani B; Ahuja, Neera; Artandi, Maja; Blish, Catherine A; Blomkalns, Andra L; Chang, Iris; Collins, William J; Desai, Manisha; Din, Hena Naz; Do, Evan; Fernandes, Andrea; Geng, Linda N; Rosenberg-Hasson, Yael; Mahoney, Megan Ruth; Glascock, Abigail L; Chan, Lienna Y; Fong, Sharon Y; Consortium, CLIAHUB; Biohub, Chan Zuckerberg; Phelps, Maira; Raeber, Olivia; Group, Stanford COVID-19 Biobank Study; Purington, Natasha; Röltgen, Katharina; Rogers, Angela J; Snow, Theo; Wang, Taia T; Solis, Daniel; Vaughan, Laura; Verghese, Michelle; Maecker, Holden; Wittman, Richard; Puri, Rajan; Kistler, Amy; Yang, Samuel; Boyd, Scott D; Pinsky, Benjamin A; Chinthrajah, Sharon; Nadeau, Kari C
Source
JCI Insight. 7(13)
Subject
Language
Abstract
BACKGROUNDProlonged symptoms after SARS-CoV-2 infection are well documented. However, which factors influence development of long-term symptoms, how symptoms vary across ethnic groups, and whether long-term symptoms correlate with biomarkers are points that remain elusive.METHODSAdult SARS-CoV-2 reverse transcription PCR-positive (RT-PCR-positive) patients were recruited at Stanford from March 2020 to February 2021. Study participants were seen for in-person visits at diagnosis and every 1-3 months for up to 1 year after diagnosis; they completed symptom surveys and underwent blood draws and nasal swab collections at each visit.RESULTSOur cohort (n = 617) ranged from asymptomatic to critical COVID-19 infections. In total, 40% of participants reported at least 1 symptom associated with COVID-19 six months after diagnosis. Median time from diagnosis to first resolution of all symptoms was 44 days; median time from diagnosis to sustained symptom resolution with no recurring symptoms for 1 month or longer was 214 days. Anti-nucleocapsid IgG level in the first week after positive RT-PCR test and history of lung disease were associated with time to sustained symptom resolution. COVID-19 disease severity, ethnicity, age, sex, and remdesivir use did not affect time to sustained symptom resolution.CONCLUSIONWe found that all disease severities had a similar risk of developing post-COVID-19 syndrome in an ethnically diverse population. Comorbid lung disease and lower levels of initial IgG response to SARS-CoV-2 nucleocapsid antigen were associated with longer symptom duration.TRIAL REGISTRATIONClinicalTrials.gov, NCT04373148.FUNDINGNIH UL1TR003142 CTSA grant, NIH U54CA260517 grant, NIEHS R21 ES03304901, Sean N Parker Center for Allergy and Asthma Research at Stanford University, Chan Zuckerberg Biohub, Chan Zuckerberg Initiative, Sunshine Foundation, Crown Foundation, and Parker Foundation.