Plasma-based antigen persistence in the post-acute phase of SARS-CoV-2 infection.
Plasma-based antigen persistence in the post-acute phase of SARS-CoV-2 infection.
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SARS-CoV-2 感染急性期后血浆抗原的持续存在。
DOI：
10.1101/2023.10.24.23297114
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Hoh,Reb
中科院分区：
文献类型：
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作者：
Peluso,MichaelJ;Swank,ZoeN;Goldberg,SarahA;Lu,Scott;Dalhuisen,Thomas;Borberg,Ella;Senussi,Yasmeen;Luna,MichaelA;Song,CelinaChang;Clark,Alexus;Zamora,Andhy;Lew,Megan;Viswanathan,Badri;Huang,Beatrice;Anglin,Khamal;Hoh,Reb
研究背景一些COVID-19患者的持续症状导致了一种假设，即SARS-CoV-2可能以某种形式或位置在急性感染后持续很长时间。几项研究已经显示了这方面的数据，但受到非代表性和小研究人群的限制，急性感染持续时间短，缺乏真正的阴性对照组来评估检测特异性. METHODS我们评估了急性感染后多个时间点的RNA确认的COVID-19成人（大流行时代参与者）和2020年之前收集标本的成人（大流行前时代）。使用一次解冻的血浆，我们采用Simoa®（Quanterix）单分子阵列检测平台来测量SARS-CoV-2刺突抗原、S1抗原和核衣壳抗原。与250名检测阳性率为2%的大流行前参与者相比，在感染后急性期的三个不同时间段，171名大流行时期参与者中任何SARS-CoV-2抗原的检测频率显著更高。SARS-CoV-2血浆抗原患病率的绝对差异为+11%（95% CI：+5.0%至+16%），COVID-19发病后3.0-6.0个月; +8.7%（95% CI：+3.1%至+14%）; 10.1- 14.1个月时为+5.4%（95% CI：+0.42%至+10%）。急性COVID-19的住院治疗，以及在急性COVID-19期间未住院的患者中，自我报告的健康状况较差与急性期后抗原检测结果相关。结论与未感染者相比，急性COVID-19后14个月内，SARS-CoV-2感染者的SARS-CoV-2抗原血症患病率过高。这些发现激发了关于这种病毒持续存在的短期和长期临床表现的紧急研究议程。
BACKGROUNDPersistent symptoms among some persons who develop COVID-19 has led to the hypothesis that SARS-CoV-2 may, in some form or location, persist for long periods following acute infection. Several studies have shown data in this regard but are limited by non-representative and small study populations, short duration since acute infection, and lack of a true-negative comparator group to assess assay specificity.METHODSWe evaluated adults with RNA-confirmed COVID-19 at multiple time points following acute infection (pandemic-era participants) and adults with specimens collected prior to 2020 (pre-pandemic era). Using once-thawed plasma, we employed the Simoa® (Quanterix) single molecule array detection platform to measure SARS-CoV-2 spike, S1, and nucleocapsid antigens.RESULTSCompared to 250 pre-pandemic participants who had 2% assay positivity, detection of any SARS-CoV-2 antigen was significantly more frequent among 171 pandemic-era participants at three different time periods in the post-acute phase of infection. The absolute difference in SARS-CoV-2 plasma antigen prevalence was +11% (95% CI: +5.0% to +16%) at 3.0–6.0 months post-onset of COVID-19; +8.7% (95% CI: +3.1% to +14%) at 6.1 to 10.0 months; and +5.4% (95% CI: +0.42% to +10%) at 10.1–14.1 months. Hospitalization for acute COVID-19 and, among the non-hospitalized, worse self-reported health during acute COVID-19 were associated with greater post-acute phase antigen detection.CONCLUSIONSCompared to uninfected persons, there is an excess prevalence of SARS-CoV-2 antigenemia in SARS-CoV-2-infected individuals up to 14 months after acute COVID-19. These findings motivate an urgent research agenda regarding the short-term and long-term clinical manifestations of this viral persistence.