OA4‐AM23‐MN‐23 | RNA Persistence, Antibody Dynamics and Symptom Outcomes in a Longitudinal Cohort of Persons Infected with SARS‐CoV‐2
Bibliographic record
Abstract
Studies of infected blood donors have contributed to understanding of diagnosis, natural history and pathogenesis of many emerging infectious diseases. The REDS-IV-P Epidemiology, Surveillance and Preparedness of the Novel SARS-CoV-2 Epidemic (RESPONSE) enrolled SARS-CoV-2 infected donors reporting post-donation information and acutely infected community participants in a prospective follow-up study to define immune and virological parameters over time and their association with clinical outcomes. Blood donors and community participants were enrolled Nov 2020 to Jan 2022 for ≤1-year follow-up with: (1) symptoms consistent with COVID infection and RNA reactive plasma or (2) positive diagnostic test. Blood and mucosal samples were characterized for viral and immune parameters. Plasma, nasal swabs, and saliva were tested for SARS-CoV-2 RNA by Grifols SARS-CoV-2 TMA. VITROS anti-SARS-CoV-2 total mucleocapsid (N) and spike (S) IgG quantitative tests were used for plasma serology testing. Buccal swab serology used the MSD V-PLEX SARS-CoV-2 Panel 2 (IgA) Kit. Study visit questionnaires captured vaccination, infection, and clinical outcome details to evaluate laboratory parameters associated with symptom persistence. RESPONSE enrolled 102 participants: 62 blood donors and 40 community participants median 7.0 days from diagnosis. Average age was 46, 62.9% were female, and 20.6% were vaccinated pre-diagnosis. RNA persisted in nasal swabs or saliva for median 31.5 (95% CI 20.5, 63.5) days (Figure 1). Persistent mucosal RNA (≥1 month from index) was associated with BMI (p = .03) but not age, sex, or chronic conditions. Twelve participants had mucosal RNA reactivity ≥90 days after last negative test indicating likely reinfection. Lower prior anti-S total Ig (p = .005) and IgG (p = .002) reactivity levels were associated with reinfection risk. Peak anti-S and anti-N Ab levels were associated with symptoms, but not age, sex, BMI or RNAemia. Cough, headache, and weakness/fatigue were reported in >62% of participants. Symptoms most likely to persist ≥2 months were diarrhea (N = 24), rash (N = 7) and change in taste/smell (N = 31) persisting in 40.7%, 58.3%, and 47.4% of those reporting the respective symptoms. Symptom persistence was associated with BMI (p = .035). Peak anti-S and anti-N Ab levels were associated with persistent symptoms but not other participant characteristics. Mucosal RNA persistence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".