Post-COVID-19 syndrome and humoral response association after one year in vaccinated and unvaccinated patients

Abstract:

Objectives: To describe the impact of vaccination and the role of humoral responses on post-coronavirus disease 2019 (COVID-19) syndrome one year after the onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods: A prospective study. Interviews investigated post-COVID-19 syndrome 6 and 12 months after the disease onset of all adult in- and outpatients with COVID-19 attending Udine Hospital (March-May 2020). Vaccination status and two different serological assays to distinguish between response to vaccination (receptor-binding domain -RBD SARS-CoV-2 IgG) and/or natural infection (non-RBD- SARS-CoV-2 IgG) were also assessed.

Results: 479 individuals (52.6% female, mean age 53 years) were interviewed 13.5 months (0.6 SD) after acute infection. Post-COVID-19 syndrome was observed in 47.2% (226/479) of patients after one year. There were no significant differences in the worsening of post-COVID 19 symptoms (22.7% vs 15.8%, p = 0.209) among vaccinated (n=132) and unvaccinated (n=347) patients. The presence of non-RBD SARS-CoV-2 IgG induced by natural infection showed a significant association with post-COVID-19 syndrome (OR 1.35, 95% CI 1.11-1.64, p = 0.003), and median non-RBD SARS-CoV-2 IgG titres were significantly higher in long-haulers than in patients without symptoms 22 (IQR 9.7-37.2) vs 14.1 (IQR 5.4-31.3) kAU/L, p = 0.009) after one year.

In contrast, the presence of RBD SARS-CoV-2 IgG was not associated with the occurrence of post-COVID-19 syndrome (>2500 U/mL vs 0.9-2500 U/mL, OR 1.36, 95% CI 0.62-3.00, p = 0.441) and RBD SARS-CoV-2 IgG titres were similar in long-haulers than in patients without symptoms (50% values > 2500 U/mL vs 55.6% values > 2500 U/mL, p = 0.451)

Conclusions: The SARS-CoV-2 vaccination is not associated with the emergence of post-COVID-19 symptoms over one year after acute infection. The persistence of high serological titres response induced by natural infection but not by vaccination, may play a role in long-COVID-19.

Source: Peghin M, De Martino M, Palese A, Gerussi V, Bontempo G, Graziano E, Visintini E, Elia D, Dellai F, Marrella F, Fabris M, Curcio F, Sartor A, Isola M, Tascini C. Post-COVID-19 syndrome and humoral response association after one year in vaccinated and unvaccinated patients. Clin Microbiol Infect. 2022 Mar 23:S1198-743X(22)00155-0. doi: 10.1016/j.cmi.2022.03.016. Epub ahead of print. PMID: 35339673; PMCID: PMC8940723.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940723/ (Full text)

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