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. 2023 Sep 8;18(9):e0291259.
doi: 10.1371/journal.pone.0291259. eCollection 2023.

Post-acute sequelae of COVID-19 and longitudinal antibody levels in a community-based cohort

Noa Kopplin  1 , Angie Garcia  1 , Annika Reczek  1 , Kate Wilkinson  1 , Sruthi Yekkaluri  1 , Caitlin C Murphy  1 , Jasmin Tiro  1 , Alagar R Muthukumar  1 , Andrew Masica  2 , Amit G Singal  1
Affiliations

Post-acute sequelae of COVID-19 and longitudinal antibody levels in a community-based cohort

Noa Kopplin et al. PLoS One. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) infection invokes variable immune responses and poses a risk of post-acute sequelae SARS-CoV-2 infection (PASC) symptoms; however, most data on natural history are derived from patients with severe infection. Further data are needed among patients with mild infection, who comprise most cases.

Methods: The Dallas Fort-Worth (DFW) COVID-19 Prevalence Study included 21,597 community-dwelling adults (ages 18-89) who underwent COVID-19 PCR and anti-nucleocapsid antibody testing between July 2020 and March 2021. We invited participants with positive COVID-19 results (cases) and a subset with negative results (controls), matched on age, sex, race/ethnicity, and ZIP code, to complete a follow-up questionnaire for PASC symptoms and repeat anti-nucleocapsid testing, and anti-spike antibody testing between July and December 2021.

Results: Of 3,917 adults invited to participate, 2260 (57.7%) completed the questionnaire- 1150 cases and 1110 controls. Persistent symptoms were reported in 21.1% of cases, with the most common being shortness of breath, fatigue, and loss of taste or smell. Among 292 cases with asymptomatic infection, >15% reported new fatigue and 8-10% reported new loss of taste/smell, myalgias, or headache. Median anti-nucleocapsid levels in cases decreased from 3.5U to 0.7U over a median follow-up of 8.6 months. Anti-spike antibody levels at 6-7 months post-vaccination in cases were similar to that of controls.

Conclusions: More than 1 in 5 patients with COVID-19 infection, including those with mild infection, reported persistent symptoms during follow-up. Both nucleocapsid and spike protein antibody levels decreased within six months following a COVID-19 infection and vaccination.

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Conflict of interest statement

None of the authors have a relevant conflict of interest.

Figures

Fig 1
Fig 1. Proportions of patients with potential COVID-19 symptoms.
Fig 2
Fig 2. Proportions of patients with potential PASC symptoms*.
*Proportions reflect a cross-sectional assessment of symptoms during follow-up as baseline measurements were not available to assess longitudinal changes.
Fig 3
Fig 3
A. Anti-nucleocapsid antibody levels during follow-up. B. Median anti-spike antibody levels during follow-up after vaccination.
See this image and copyright information in PMC

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