Clinical and serological predictors of post COVID-19 condition – findings from a Canadian prospective cohort study
- DOI
- Language of the publication
- English
- Date
- 2023-08-05
- Type
- Submitted manuscript
- Author(s)
- Collins, Erin
- Arnold, Corey
- Bhéreur, Anne
- Booth, Ronald
- Buchan, Arianne C.
- Cooper, Curtis
- Crawley, Angela M.
- McCluskie, Pauline S.
- McGuinty, Michaeline
- Pelchat, Martin
- Rocheleau, Lynda
- Saginur, Raphael
- Gravel, Chris
- Hawken, Steven
- Langlois, Marc-André
- Little, Julian
- Little, Julian
- Publisher
- medRxiv
Abstract
INTRODUCTION: More than three years into the pandemic, there is persisting uncertainty as to the etiology, biomarkers, and risk factors of Post COVID-19 Condition (PCC). Serological research data remain a largely untapped resource. Few studies have investigated the potential relationships between post-acute serology and PCC, while accounting for clinical covariates. METHODS: We compared clinical and serological predictors among COVID-19 survivors with (n=102 cases) and without (n=122 controls) persistent symptoms ≥12 weeks post-infection. We selected four primary serological predictors (anti-nucleocapsid (N), anti-Spike, and anti-receptor binding domain (RBD) IgG titres, and neutralization efficiency), and specified clinical covariates a priori. RESULTS: Similar proportions of PCC-cases (66.7%, n=68) and infected-controls (71.3%, n=87) tested positive for anti-N IgG. More cases tested positive for anti-Spike (94.1%, n=96) and anti-RBD (95.1%, n=97) IgG, as compared with controls (anti-Spike: 89.3%, n=109; anti-RBD: 84.4%, n=103). Similar trends were observed among unvaccinated participants. Effects of IgG titres on PCC status were non-significant in univariate and multivariate analyses. Adjusting for age and sex, PCC-cases were more likely to be efficient neutralizers (OR 2.2, 95% CI 1.11 – 4.49), and odds was further increased among cases to report deterioration in quality of life (OR 3.4, 95% CI 1.64 – 7.31). Clinical covariates found to be significantly related to PCC included obesity (OR 2.3, p=0.02), number of months post COVID-19 (OR 1.1, p<0.01), allergies (OR 1.8, p=0.04), and need for medical support (OR 4.1, p<0.01). CONCLUSION: Despite past COVID-19 infection, approximately one third of PCC-cases and infected-controls were seronegative for anti-N IgG. Findings suggest higher neutralization efficiency among cases as compared with controls, and that this relationship is stronger among cases with more severe PCC. Cases also required more medical support for COVID-19 symptoms, and described complex, ongoing health sequelae. More data from larger cohorts are needed to substantiate results, permit subgroup analyses of IgG titres, and explore for differences between clusters of PCC symptoms. Future assessment of IgG subtypes may also elucidate new findings.
Subject
- Health,
- Coronavirus diseases
Rights
Pagination
1-33
Peer review
No
Article
- Submitted date
- 2023-08-11
Sponsors
FUNDING STATEMENT: EC is supported by the AI4PH Scholarship Program, funded by CIHR. YG is supported by a Charles Best and Frederick Banting (CGS-Doctoral award) from CIHR (476885). The Stop the Spread Ottawa study is funded by the Canadian Institutes of Health Research (CIHR) (424425), the COVID-19 Immunity Task Force (CITF), and the University of Ottawa. The study extension is funded by the Coronavirus Variants Rapid Response Network (CoVaRR-Net) (156941). CoVaRR-Net is funded by an operating grant from CIHR (FRN 175622). We also acknowledge in-kind support from the NRC Pandemic Response Challenge Program.