Abstract: One in ten SARS-CoV-2 infections result in prolonged symptoms termed ‘long COVID’, yet disease phenotypes and mechanisms are poorly understood. We studied the blood proteome of 719 previously hospitalised adults with long COVID grouped by symptoms. Elevated markers of myeloid inflammation and complement activation were associated with long COVID; elevated IL1R2, MATN2 and COLEC12 were associated with cardiorespiratory symptoms, fatigue, and anxiety/depression, while MATN2 and DPP10 were elevated in gastrointestinal (GI) symptoms, and C1QA in cognitive impairment. Markers of neuroinflammation and altered tissue repair were elevated in cognitive impairment, whilst SCG3 (indicative of brain-gut axis disturbance) was specific to GI symptoms. Nasal inflammation was apparent after COVID-19 but did not associate with symptoms. Although SARS-CoV-2 specific IgG was elevated with some long COVID symptoms, virus was not detected from sputum. Thus, systemic inflammation is evident in long COVID and could be targeted in therapeutic trials tailored to pathophysiological differences between symptom groups.
This work is currently under revision. The preprint is available: Liew et al., 2023 https://www.medrxiv.org/content/10.1101/2023.06.07.23291077v1
Bio: Dr Felicity Liew MRCP, MBBS, BSc(hons) is a Clinical Research Fellow and Respiratory Registrar at the National Heart & Lung Institute, Imperial College London/ St Mary’s Hospital. She completed her undergraduate medical degree and intercalated BSc at University College London, and subsequently gained an integrated Clinical-Academic Foundation Programme position in Public Health at Imperial College London and Imperial Healthcare NHS Trust. She started specialty training in Respiratory Medicine as an NIHR Academic Clinical Fellow in 2019 within the Northwest London Deanery. Her clinical and research interests focus on respiratory infection and its long-term impact on health. She is passionate about better understanding social determinants of health and addressing inequalities in healthcare, recently receiving a certification in Healthcare Equality and Policy from the London School of Economics. She is currently holding an MRC training fellowship, undertaking a PhD with Professor Peter Openshaw. Her project focusses on long term immune responses after COVID-19 working within the PHOSP-COVID and ISARIC4C consortia.
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