Common coronavirus may prime immune system to develop long COVID
Previous infection with an endemic coronavirus that causes the common cold may predispose COVID-19 patients with rheumatic disease to persistent symptoms, a Brigham and Women’s Hospital-led study suggests.
Published yesterday in Science Translational Medicine, the study involved serologic testing for antibodies against SARS-CoV-2, a panel of endemic pathogens, and a panel of routine vaccine antigens in two groups of patients with pre-existing systemic autoimmune rheumatic disease (SARD) who either did or didn’t develop long COVID, or post-acute sequelae of COVID-19 (PASC).
The team first analyzed a discovery cohort recruited before December 13, 2021, to identify potential antibody profiles tied to long COVID, then replicated the results in a validation cohort recruited from December 14, 2021, to September 16, 2022.
SARD patients, who have illnesses such as rheumatoid arthritis or other inflammatory autoimmune diseases, are at increased risk for severe COVID-19.
Partial COVID immunity, control, clearance
Up to 45% of SARD patients experienced long COVID 28 days after infection. The researchers observed that long-COVID patients had weaker Fcγ receptor (FcγR)-binding anti–SARS-CoV-2 antibodies and stronger Fcγ receptor (FcγR)-binding pro-inflammatory antibody responses against the endemic coronavirus OC43 linked to cross-reactivity against SARS-CoV-2 and common coronaviruses.
“Rather than identifying an autoimmune marker of PASC, these results from two independent cohorts point to immunological imprinting by human endemic coronaviruses in patients with SARDs and PASC that may result in the generation of incomplete SARS-CoV-2 immunity, control, and clearance,” the study authors wrote.