Persistence of SARS CoV-2 S1 Protein in CD16+ Monocytes in Post-Acute Sequelae of COVID-19 (PASC) up to 15 Months Post-Infection

The recent COVID-19 pandemic is a treatment challenge in the acute infection stage but the recognition of chronic COVID-19 symptoms termed post-acute sequelae SARS-CoV-2 infection (PASC) may affect up to 30% of all infected individuals. The underlying mechanism and source of this distinct immunologi...

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Published in:	Frontiers in immunology Vol. 12; p. 746021
Main Authors:	Patterson, Bruce K, Francisco, Edgar B, Yogendra, Ram, Long, Emily, Pise, Amruta, Rodrigues, Hallison, Hall, Eric, Herrera, Monica, Parikh, Purvi, Guevara-Coto, Jose, Triche, Timothy J, Scott, Paul, Hekmati, Saboor, Maglinte, Dennis, Chang, Xaiolan, Mora-Rodríguez, Rodrigo A, Mora, Javier
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 10-01-2022
Subjects:	Adult CCR5 COVID-19 COVID-19 - immunology Female Flow Cytometry Follow-Up Studies fractalkine GPI-Linked Proteins - immunology Humans Immunology Male Middle Aged Monocytes - immunology non-classical monocytes PASC Receptors, IgG - immunology SARS CoV-2 S1 protein SARS-CoV-2 - immunology Spike Glycoprotein, Coronavirus - immunology COVID-19 SARS CoV-2 S1 protein PASC CCR5 fractalkine non-classical monocytes
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Summary:	The recent COVID-19 pandemic is a treatment challenge in the acute infection stage but the recognition of chronic COVID-19 symptoms termed post-acute sequelae SARS-CoV-2 infection (PASC) may affect up to 30% of all infected individuals. The underlying mechanism and source of this distinct immunologic condition three months or more after initial infection remains elusive. Here, we investigated the presence of SARS-CoV-2 S1 protein in 46 individuals. We analyzed T-cell, B-cell, and monocytic subsets in both severe COVID-19 patients and in patients with post-acute sequelae of COVID-19 (PASC). The levels of both intermediate (CD14+, CD16+) and non-classical monocyte (CD14Lo, CD16+) were significantly elevated in PASC patients up to 15 months post-acute infection compared to healthy controls (P=0.002 and P=0.01, respectively). A statistically significant number of non-classical monocytes contained SARS-CoV-2 S1 protein in both severe (P=0.004) and PASC patients (P=0.02) out to 15 months post-infection. Non-classical monocytes were sorted from PASC patients using flow cytometric sorting and the SARS-CoV-2 S1 protein was confirmed by mass spectrometry. Cells from 4 out of 11 severe COVID-19 patients and 1 out of 26 PASC patients contained ddPCR+ peripheral blood mononuclear cells, however, only fragmented SARS-CoV-2 RNA was found in PASC patients. No full length sequences were identified, and no sequences that could account for the observed S1 protein were identified in any patient. That non-classical monocytes may be a source of inflammation in PASC warrants further study.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Aurelio Cafaro, National Institute of Health (ISS), Italy This article was submitted to Viral Immunology, a section of the journal Frontiers in Immunology Reviewed by: Suresh Pallikkuth, University of Miami, United States; P. W. Askenase, Yale University, United States; Roberto Accinelli, Universidad Peruana Cayetano Heredia, Peru
ISSN:	1664-3224 1664-3224
DOI:	10.3389/fimmu.2021.746021