ArticleFrontiers in immunology2023
Post-COVID symptoms are associated with endotypes reflecting poor inflammatory and hemostatic modulation.
Article in Frontiers in immunology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Barriers to Long COVID Care in the U.S.: An Application of Levesque et al.'s Access Framework.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Persistent Immune Dysregulation during Long COVID is Manifested in Antibodies Targeting Envelope and Nucleocapsid Proteins.Research square · 2026Article
- A perfect storm: the immunological and pathophysiological landscape of pediatric post-COVID-19 condition.Frontiers in immunology · 2026Review
- Longitudinal gene expression analysis in COVID-19 sepsis highlights dynamic immune, cellular, and metabolic dysfunction in high severity patients.Scientific reports · 2025Article
- Persistent Immune Dysregulation during Post-Acute Sequelae of COVID-19 is Manifested in Antibodies Targeting Envelope and Nucleocapsid Proteins.bioRxiv : the preprint server for biology · 2025Article
- A machine learning and centrifugal microfluidics platform for bedside prediction of sepsis.Nature communications · 2025Article
- Association of systemic inflammation and long-term dysfunction in COVID-19 patients: A prospective cohort.Psychoneuroendocrinology · 2025Article
- Patients with post-COVID-19 condition show minor blood transcriptomic changes, with altered erythrocyte gene expression in a male subgroup.Frontiers in immunology · 2025Article
- Exploration of risk factors and characteristics of COVID-19 infection among patients with hematological malignancies in Suzhou, China: a retrospective study.Frontiers in oncology · 2024Article
- Col1α2-Cre-mediated recombination occurs in various cell types due to Cre expression in epiblasts.Scientific reports · 2023Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
Introduction: Persistent symptoms after COVID-19 infection ("long COVID") negatively affects almost half of COVID-19 survivors. Despite its prevalence, its pathophysiology is poorly understood, with multiple host systems likely affected. Here, we followed patients from hospital to discharge and used a systems-biology approach to identify mechanisms of long COVID. Methods: RNA-seq was performed on whole blood collected early in hospital and 4-12 weeks after discharge from 24 adult COVID-19 patients (10 reported post-COVID symptoms after discharge). Differential gene expression analysis, pathway enrichment, and machine learning methods were used to identify underlying mechanisms for post-COVID symptom development. Results: Compared to patients with post-COVID symptoms, patients without post-COVID symptoms had larger temporal gene expression changes associated with downregulation of inflammatory and coagulation genes over time. Patients could also be separated into three patient endotypes with differing mechanistic trajectories, which was validated in another published patient cohort. The "Resolved" endotype (lowest rate of post-COVID symptoms) had robust inflammatory and hemostatic responses in hospital that resolved after discharge. Conversely, the inflammatory/hemostatic responses of "Suppressive" and "Unresolved" endotypes (higher rates of patients with post-COVID symptoms) were persistently dampened and activated, respectively. These endotypes were accurately defined by specific blood gene expression signatures (6-7 genes) for potential clinical stratification. Discussion: This study allowed analysis of long COVID whole blood transcriptomics trajectories while accounting for the issue of patient heterogeneity. Two of the three identified and externally validated endotypes ("Unresolved" and "Suppressive") were associated with higher rates of post-COVID symptoms and either persistently activated or suppressed inflammation and coagulation processes. Gene biomarkers in blood could potentially be used clinically to stratify patients into different endotypes, paving the way for personalized long COVID treatment.
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