Persistent Circulating SARS-CoV-2 Spike is Associated with Post-acute COVID-19 Sequelae

Zoe Swank, Yasmeen Senussi, Galit Alter, David R. Walt

The diagnosis and management of post-acute sequelae of COVID-19 (PASC) poses an
ongoing medical challenge … [T]emporal antigen profiles for many patients show the
presence of spike at multiple time points over several months, highlighting the potential
utility of the SARS-CoV-2 full spike protein as a biomarker for PASC.

… We analyzed plasma samples from a cohort of 63 individuals previously infected with
SARS-CoV-2, 37 of whom were diagnosed with PASC.

… Most notably, we detected circulating SARSCoV-2 spike in the majority of PASC patients, but in none of the COVID-19 patients.

… In conclusion, the presence of circulating spike in PASC patients up to 12 months
post-diagnosis strongly suggests that SARS-CoV-2 viral reservoirs persist in the body.
Additionally, the detection of spike in a majority of individuals included in our PASC cohort
provides strong support for the use of spike as a biomarker for PASC. If PASC patients
can be identified based on the direct measurement of spike protein, characterizing patient
phenotypes and assessing treatment strategies will become increasingly effective.

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