'The long tail of Covid-19' - The detection of a prolonged inflammatory response after a SARS-CoV-2 infection in asymptomatic and mildly affected patients

Abstract

'Long Covid', or medical complications associated with post SARS-CoV-2 infection, is a significant post-viral complication that is being more and more commonly reported in patients. Therefore, there is an increasing need to understand the disease mechanisms, identify drug targets and inflammatory processes associated with a SARS-CoV-2 infection. To address this need, we created a targeted mass spectrometry based multiplexed panel of 96 immune response associated proteins. We applied the multiplex assay to a cohort of serum samples from asymptomatic and moderately affected patients. All patients had tested positive for a SARS-CoV-2 infection by PCR and were determined to be subsequently positive for antibodies. Even 40-60 days post-viral infection, we observed a significant remaining inflammatory response in all patients. Proteins that were still affected were associated with the anti-inflammatory response and mitochondrial stress. This indicates that biochemical and inflammatory pathways within the body can remain perturbed long after SARS-CoV-2 infections have subsided even in asymptomatic and moderately affected patients.

Keywords: Sars-CoV-2; biomarker; inflammation; mass spectrometry; proteomics.

Figure 1.. Multivariate analysis of post infection serum inflammation profile.

a) Representative overlaid chromatogram of the multiplex inflammation panel. Protein identifiers indicated by name and followed by first three amino acids of the peptide. b) Principle component analysis score plot of 10 SARS-Cov-2 infected patients >40 days post infection and 10 negative controls.

Figure 2.. Altered proteins in post infection serum.

Proteins significantly affected (p< 0.001) by non-parametric statistical analysis in the serum of >40 day post SARS-Cov-2 infected healthcare workers **** p<0.0001, ***p<0.001, **p<0.01, *p<0.01.