Novel clinical and immunological features associated with persistent post-acute sequelae of COVID-19 after six months of follow-up: a pilot study
Jiram Torres‐Ruiz, Julieta Lomelín‐Gascón, Jaquelin Lira Luna, Ana Sofía Vargas-Castro, Alfredo Pérez‐Fragoso, Miroslava Nuñez‐Aguirre, Beatriz Alcalá‐Carmona, Abdiel Absalón‐Aguilar, Jennifer Balderas-Miranda, José Luis Maravillas‐Montero, Nancy R. Mejía‐Domínguez, Carlos A. Núñez‐Álvarez, Luis Llorente, Sandra Romero‐Ramírez, Víctor A. Sosa‐Hernández, Rodrigo Cervantes‐Díaz, Guillermo Juárez‐Vega, David Eduardo Meza-Sánchez, Marina Rull‐Gabayet, Luis Alberto Martínez‐Juárez, Linda Morales, Lizeth Lopez-Lopez, José Adrián Negrete‐Trujillo, Jorge Abelardo Falcón‐Lezama, Rafael Ricardo Valdez‐Vázquez, Héctor Gallardo‐Rincón, Roberto Tapia‐Conyer, Diana Gómez‐Martín
Abstract
Background Currently, there is scant information regarding the features associated to the persistence of post-COVID-19 syndrome, which is the main aim of the present study.Methods A cohort study of 102 COVID-19 patients was conducted. The post-COVID-19 symptoms were assessed by a standardised questionnaire. Lymphocyte immunophenotyping was performed by flow cytometry and chemokines/cytokines, neutrophil extracellular traps, the tripartite motif 63, anti-cellular, and anti-SARS-CoV-2 IgG antibodies were addressed in serum. The primary outcome was the persistence of post-COVID-19 syndrome after six months follow-up.Results Thirteen patients (12.7%) developed the primary outcome and had a more frequent history of post-COVID-19 syndrome 3 months after infection onset (p = .044), increased levels of IL-1α (p = .011) and IP-10 (p = .037) and increased CD57 expression in CD8+ T cells (p = .003). There was a trend towards higher levels of IFN-γ (p = .051), IL-1β (p = .062) and IL-6 (p = .087). The history of post COVID-19 in the previous 3 months, obesity, baseline serum MIP-1α and IP-10, and CD57 expression in CD8+ T cells were independently associated with the persistence of post-COVID-19 syndrome.Conclusion Our data suggest an important relationship between a pro-inflammatory state mediated through metabolic pathways related to obesity and increased cellular senescence as a key element in the persistence of post-COVID-19 syndrome at six months of follow-up.