Persistent symptoms after COVID-19 are not associated with differential SARS-CoV-2 antibody or T cell immunity
Daniel M. Altmann, Catherine J. Reynolds, George Joy, Ashley Otter, Joseph M. Gibbons, Corinna Pade, Leo Swadling, Mala K. Maini, Tim Brooks, Amanda Semper, Áine McKnight, Mahdad Noursadeghi, Charlotte Manisty, Thomas A. Treibel, James Moon, COVIDsortium investigators, Rosemary J. Boyton
Abstract
Among the unknowns in decoding the pathogenesis of SARS-CoV-2 persistent symptoms in Long Covid is whether there is a contributory role of abnormal immunity during acute infection. It has been proposed that Long Covid is a consequence of either an excessive or inadequate initial immune response. Here, we analyze SARS-CoV-2 humoral and cellular immunity in 86 healthcare workers with laboratory confirmed mild or asymptomatic SARS-CoV-2 infection during the first wave. Symptom questionnaires allow stratification into those with persistent symptoms and those without for comparison. During the period up to 18-weeks post-infection, we observe no difference in antibody responses to spike RBD or nucleoprotein, virus neutralization, or T cell responses. Also, there is no difference in the profile of antibody waning. Analysis at 1-year, after two vaccine doses, comparing those with persistent symptoms to those without, again shows similar SARS-CoV-2 immunity. Thus, quantitative differences in these measured parameters of SARS-CoV-2 adaptive immunity following mild or asymptomatic acute infection are unlikely to have contributed to Long Covid causality. ClinicalTrials.gov (NCT04318314).