Long COVID brain fog and muscle pain are associated with longer time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute infection.
Long COVID brain fog and muscle pain are associated with longer time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute infection.
复制标题
长时间的新冠病毒脑雾和肌肉疼痛与急性感染期间从上呼吸道清除 SARS-CoV-2 RNA 的时间较长有关。
DOI：
10.1101/2023.01.18.23284742
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
OutSMARTStudyGroup
中科院分区：
文献类型：
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作者：
Antar,AnnukkaAR;Yu,Tong;Demko,ZoeO;Hu,Chen;Tornheim,JeffreyA;Blair,PaulW;Thomas,DavidL;Manabe,YukariC;OutSMARTStudyGroup
引言长期COVID的发病率很高，即使在轻度至中度急性COVID-19患者中也是如此。早期病毒动力学在长期COVID的后续发展中的作用在很大程度上是未知的，特别是在未因急性COVID-19住院的个体中。Methods 73名未住院的成年参与者在首次SARS-CoV-2 RT-PCR检测阳性后约48小时内入组，在入组后的前45天内收集中鼻甲鼻和唾液样本多达9次。使用RT-PCR对样本进行SARS-CoV-2检测，并从临床记录中提取其他SARS-CoV-2检测结果。每位参与者在COVID-19诊断后1个月、3个月、6个月、12个月和18个月时指出了49种长期COVID症状的存在和严重程度。从急性COVID-19疾病发作到SARS-CoV-2 RNA清除大于或小于28天的时间与急性COVID-19症状发作后90天以上49种长COVID症状中每一种的存在或不存在的相关性进行了测试。19例发病与急性COVID-19发病后28天内的病毒RNA清除呈负相关，并对年龄、性别、BMI ≥ 25和COVID-19前的COVID疫苗接种状态进行了调整（脑雾：aRR 0.46，95% CI 0.22-0.95;肌肉疼痛：aRR 0.28，95% CI 0.08-0.94）。在急性COVID-19发病后90天以上报告严重脑雾或肌肉疼痛的参与者在28天内清除SARS-CoV-2 RNA的可能性较小。在急性COVID-19发病后90天以上经历脑雾和后来没有经历脑雾的参与者的急性病毒RNA衰减轨迹是不同的。讨论这项工作表明，在急性COVID-19发病后90天以上，至少有两种长期COVID症状-脑雾和肌肉疼痛与SARS-CoV清除时间延长特别相关。2急性COVID-19期间来自上呼吸道的RNA。这一发现提供了证据，表明在急性COVID-19期间，SARS-CoV-2抗原的延迟免疫清除或上呼吸道中病毒抗原负荷的更大数量或持续时间与长期COVID直接相关。这项工作表明，急性COVID-19发病后最初几周内的宿主-病原体相互作用会对数月后的COVID长期风险产生影响。
IntroductionThe incidence of long COVID is substantial, even in people with mild to moderate acute COVID-19. The role of early viral kinetics in the subsequent development of long COVID is largely unknown, especially in individuals who were not hospitalized for acute COVID-19.MethodsSeventy-three non-hospitalized adult participants were enrolled within approximately 48 hours of their first positive SARS-CoV-2 RT-PCR test, and mid-turbinate nasal and saliva samples were collected up to 9 times within the first 45 days after enrollment. Samples were assayed for SARS-CoV-2 using RT-PCR and additional SARS-CoV-2 test results were abstracted from the clinical record. Each participant indicated the presence and severity of 49 long COVID symptoms at 1-, 3-, 6-, 12-, and 18-months post-COVID-19 diagnosis. Time from acute COVID-19 illness onset to SARS-CoV-2 RNA clearance greater or less than 28 days was tested for association with the presence or absence of each of 49 long COVID symptoms at 90+ days from acute COVID-19 symptom onset.ResultsSelf-reported brain fog and muscle pain at 90+ days after acute COVID-19 onset were negatively associated with viral RNA clearance within 28 days of acute COVID-19 onset with adjustment for age, sex, BMI ≥ 25, and COVID vaccination status prior to COVID-19 (brain fog: aRR 0.46, 95% CI 0.22-0.95; muscle pain: aRR 0.28, 95% CI 0.08-0.94). Participants reporting higher severity brain fog or muscle pain at 90+ days after acute COVID-19 onset were less likely to have cleared SARS-CoV-2 RNA within 28 days. The acute viral RNA decay trajectories of participants who did and did not later go on to experience brain fog 90+ days after acute COVID-19 onset were distinct.DiscussionThis work indicates that at least two long COVID symptoms - brain fog and muscle pain – at 90+ days from acute COVID-19 onset are specifically associated with prolonged time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute COVID-19. This finding provides evidence that delayed immune clearance of SARS-CoV-2 antigen or greater amount or duration of viral antigen burden in the upper respiratory tract during acute COVID-19 are directly linked to long COVID. This work suggests that host-pathogen interactions during the first few weeks after acute COVID-19 onset have an impact on long COVID risk months later.