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Interactions and clinical implications of serological and respiratory variables 3 months after acute COVID-19

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Abstract

Medical follow-up of symptomatic patients after acute Coronavirus Disease 2019 (COVID-19) results in major burdens on patients and healthcare systems. The value of serological markers as part of this follow-up remains undetermined. We aimed to evaluate the clinical implications of serological markers for follow-up of acute COVID-19. For this purpose, we conducted an observational cohort study of patients 3 months after acute COVID-19. Participants visited a respiratory-clinic between October 2020 and March 2021, and completed pulmonary function tests (PFTs), serological tests, symptom-related questionnaires, and chest CT scans. Overall, 275 patients were included at a median of 82 days (IQR 64–111) post infection. 162 (59%) patients had diffusing capacity for carbon monoxide corrected for hemoglobin (DLCOc) below 80%, and 69 (25%) had bilateral chest abnormalities on CT scan. In multivariate analysis, anti-S levels were an independent predictor for DLCOc (β = − 0.14, p = 0.036). Anti-S levels were also associated with severe COVID-19 and older age, and correlated with anti-nucleocapsid (r = 0.30, p < 0.001) and antibodies to receptor binding domain (RBD, r = 0.37, p < 0.001). Other serological variables were not associated with clinical outcomes. In conclusion, symptomatic patients 3-months after COVID-19 had high respiratory symptomatic burden, in which anti-S levels were significantly associated with previous severe COVID-19 and DLCOc.

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Data availability

All data generated or analyzed during this study are included in this article. Due to ethical and privacy concerns the primary dataset cannot be made openly available. The study was done retrospectively and according to the regulations of our institution review board such data could be openly shared. Request for the dataset supporting our results can be made and will be given by the first author after approval.

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Authors and Affiliations

  1. The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Waizman 6, Tel Aviv, Israel

    Ophir Freund, Sabrina Fried, Eyal Kleinhendler, Avraham Unterman, Shir Frydman & Amir Bar-Shai

  2. Division of Pulmonary Medicine, Barzilai University Medical Center, Ashkelon, and Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Anna Breslavsky & Ori Wand

  3. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Rotem Givoli-Vilensky, Shira Cohen-Rubin, Nadav Zacks & Natalya Bilenko

  4. Medical Office of Southern District, Ministry of Health, Ashkelon, Israel

    Natalya Bilenko

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  1. Ophir Freund
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Contributions

ABS conceived and designed the study. OF drafted the manuscript. ABS supervised the study. OF, SF, SFR, NB, and EK performed data analysis. OW, NZ, SCR, RGV, AU, and AB performed data acquisition. All authors critically revised the manuscript and approved the final version.

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Correspondence to Ophir Freund.

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The authors do not have any relevant conflict of interests.

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The study was approved by the Barzilai Medical Center review board. All included patients singed informed consent.

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Freund, O., Breslavsky, A., Fried, S. et al. Interactions and clinical implications of serological and respiratory variables 3 months after acute COVID-19. Clin Exp Med 23, 3729–3736 (2023). https://doi.org/10.1007/s10238-023-01139-5

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