Nature Medicine: A number of different pathways are associated with the sequelae of the new crown

Many COVID-19-related acute sequelae include fatigue, brain fog, and loss of smell and taste
.
Researchers at the Icahn School of Medicine at Mount Sinai have published a study linking changes in blood gene expression during COVID-19 to the acute sequelae of SARS-CoV-2 infection
.

The findings, published in the journal Nature Medicine, highlight the need for more attention during the infection phase to better understand how these processes begin and eventually lead to long COVID, which promises to provide more prevention strategies and treatment options
for COVID-19 patients who develop persistent symptoms after infection.

The research team found that two different long COVID symptoms had opposite gene expression patterns
during COVID-19.
In patients who later develop lung problems, the abundance of antibody-producing genes is lower
.
However, for patients with other symptoms, such as loss of smell or taste and disrupted sleep, the same antibody-producing genes are more abundant
.

Their observation of these opposing gene expression patterns in the same cell, along with other unique patterns observed in other cell types, suggests that there are multiple independent processes that lead to different long COVID symptoms that already exist
during acute infection.

Co-corresponding author Dr.
Noam D.
Beckmann, assistant professor at the Icahn School of Medicine at Mount Sinai, said: "Our results suggest that the molecular processes that lead to long COVID-19 infection are already detectable
during COVID-19 infection.
In addition, we have seen that several different pathways can lead to long COVID, which provides a unique perspective
on the differences in long-term symptoms in different patients.
”

Using the Mount Sinai COVID-19 Biobank, the researchers tested gene expression data
from blood samples from more than 500 patients hospitalized with COVID-19 between April and June 2020.
Of those, more than 160 patients provided self-reported symptom assessments that persisted
six months or more after hospitalization.

They examined the correlation of each gene expressed in the blood with each long COVID symptom, taking into account ICU admissions, severity of COVID-19 during hospitalization, gender, age, and other variables
.
The team then analyzed the specific associations
of 13 different types of immune cells, including plasma cells.
Finally, they categorized
patients based on whether they matched changes in their antibody levels.

Lead author Dr.
Ryan C.
Thompson, a data science analyst at the Icahn School of Medicine at Mount Sinai, said: "For symptoms of long new crowns, such as smell or taste problems, antibody gene expression in plasma cells is associated with actual antibody levels against spike proteins in the body, indicating a direct link
to the body's response to the virus.
On the other hand, the gene expression pattern of lung disease does not match the level of antibodies in the body, which highlights the different
immune processes that lead to long new crowns.
”

The research team said that the current definition of long new crown is still vague, and future studies should consider the initial stage of infection to more fully describe the molecular process of long new crown and identify biomarkers that can help predict, treat and prevent long-term symptoms
.

"Our findings suggest that data from the stage of infection may be able to predict what happens to patients months later," said
co-corresponding author Alexander W.
Charney, associate professor of genetics and genomic sciences.
"We shouldn't lose sight of the infection phase in the long COVID study – it's clearly a critical window of time that hopefully sets the stage
for what happens in the future.
"

Original search

Thompson, R.
C.
, Simons, N.
W.
, Wilkins, L.
et al.
Molecular states during acute COVID-19 reveal distinct etiologies of long-term sequelae.
Nat Med (2022).
https://doi.
org/10.
1038/s41591-022-02107-4