Improvement of immune dysregulation and health-related quality of life in individuals with long COVID at 24-months following SARS-CoV-2 infection
Phetsouphanh, C.; Jacka, B.; Ballouz, S.; Jackson, K. J.; Wilson, D. B.; Manandhar, B.; Klemm, V.; Tan, H.-X.; Wheatley, A.; Aggarwal, A.; Akerman, A.; Milogiannakis, V.; Starr, M.; Cunningham, P.; Turville, S. G.; Kent, S. J.; Byrne, A.; Brew, B. J.; Darley, D. R.; Dore, G. J.; Kelleher, A. D.; Matthews, G. V.
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This study investigated the humoral and cellular immune responses in individuals with long COVID (LC) compared to age and gender matched recovered COVID-19 controls (MC) over 24-months. LC participants showed elevated spike and nucleocapsid IgG levels, higher neutralizing capacity, and increased spike- and nucleocapsid-specific CD4+ T cells, PD-1, and TIM-3 expression on CD4+ and CD8+ T cells at 3- and 8-months, but these differences did not persist at 24-months. Some LC participants had detectable IFN-{gamma} and IFN-{beta}, that was attributed to reinfection and antigen re-exposure. Single-cell RNA sequencing at 24-month timepoint revealed similar immune cell proportions and reconstitution of naive T and B cell subsets in LC. No significant differences in exhaustion scores or antigen-specific T cell clones were observed. These findings suggest resolution of immune activation in LC and return to comparable immune responses between LC and MC over time. Improvement in self-reported health-related quality of life at 24-months was also evident in the majority of LC (62%). PTX3, CRP levels and platelet count were associated with improvements in health-related quality of life.
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