IgG4 serum levels are not elevated in cases of Post-COVID syndrome

Abel, Jonas; Walter, Annika J.; Glück, Vivian; Magnus, Clara Luzia; Glück, Thomas; Schuster, Philipp; Blaas, Stefan; Montanari, Ida; Koller, Michael; Mohr, Arno; Hinterberger, Thilo; Salzberger, Bernd; Renner, Karl; Mack, Matthias; Bals, Robert; Schmidt, Tina; Klemis, Verena; Sester, Martina; Kardashi, Romina; With, Katja de; Loew, Thomas; Malfertheiner, Maximilian; Pfeifer, Michael; Gessner, André; Schmidt, Bárbara; Schmalenberger, Daniel; Peterhoff, David

doi:10.1101/2023.03.01.530454

Cited by 2 publications

(2 citation statements)

References 11 publications

(16 reference statements)

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“…While recent reports have found unexpectedly high virus-specific IgG4 levels after more than two mRNA vaccinations [49,50], another report has observed low total IgG4 levels in 64 PCC samples with small but significant difference for the spike protein receptorbinding domain that may contribute to chronic inflammation [51]. As the authors of those recent publications have not clarified the disease severity in the reported patients, our novel finding of significantly upregulated IgG4 levels in patients with deep phenotyping of particularly severe disease course with concomitant ME/CFS may serve as groundwork for future functional studies.…”

Section: Potential Immune Dysregulation As a Risk Factor For Pediatri...mentioning

confidence: 91%

Atopy and Elevation of IgE, IgG3, and IgG4 May Be Risk Factors for Post COVID-19 Condition in Children and Adolescents

Körner,

Bansemir,

Franke

et al. 2023

Children

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SARS-CoV-2 infection causes transient cardiorespiratory and neurological disorders, and severe acute illness is rare among children. Post COVID-19 condition (PCC) may cause profound, persistent phenotypes with increasing prevalence. Its manifestation and risk factors remain elusive. In this monocentric study, we hypothesized that atopy, the tendency to produce an exaggerated immunoglobulin E (IgE) immune response, is a risk factor for the manifestation of pediatric PCC. We present a patient cohort (n = 28) from an early pandemic period (2021–2022) with comprehensive evaluations of phenotypes, pulmonary function, and molecular investigations. PCC predominantly affected adolescents and presented with fatigue, dyspnea, and post-exertional malaise. Sensitizations to aeroallergens were found in 93% of cases. We observed elevated IgE levels (mean 174.2 kU/L, reference < 100 kU/L) regardless of disease severity. Concurrent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) was found in 29% of patients that also faced challenges in school attendance. ME/CFS manifestation was significantly associated with elevated immunoglobulin G subclasses IgG3 (p < 0.05) and IgG4 (p < 0.05). A total of 57% of patients showed self-limiting disease courses with mean recovery at 12.7 months (range 5–25 months), 29% at 19.2 months (range 12–30 months), and the rest demonstrated overall improvement. These findings offer additional insights into immune dysregulation as a risk factor for pediatric PCC.

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Section: Potential Immune Dysregulation As a Risk Factor For Pediatri...mentioning

confidence: 91%

Atopy and Elevation of IgE, IgG3, and IgG4 May Be Risk Factors for Post COVID-19 Condition in Children and Adolescents

Körner,

Bansemir,

Franke

et al. 2023

Children

View full text Add to dashboard Cite

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“…Consequently, examining the distribution patterns of IgG subtypes holds promise for uncovering nuanced insights into SARS-CoV-2 immune response, and potentially elucidating connections between clinical risk factors, serological markers, and post-acute sequelae. However, as yet there are few reports on IgG subtypes in relation to PCC and this is a gap that warrants comprehensive investigation ( 16 , 71 , 72 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical and serological predictors of post COVID-19 condition–findings from a Canadian prospective cohort study

Collins,

Galipeau,

Arnold

et al. 2024

Front. Public Health

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IntroductionMore than 3 years into the pandemic, there is persisting uncertainty as to the etiology, biomarkers, and risk factors of Post COVID-19 Condition (PCC). Serological research data remain a largely untapped resource. Few studies have investigated the potential relationships between post-acute serology and PCC, while accounting for clinical covariates.MethodsWe compared clinical and serological predictors among COVID-19 survivors with (n = 102 cases) and without (n = 122 controls) persistent symptoms ≥12 weeks post-infection. We selected four primary serological predictors (anti-nucleocapsid (N), anti-Spike, and anti-receptor binding domain (RBD) IgG titres, and neutralization efficiency), and specified clinical covariates a priori.ResultsSimilar proportions of PCC-cases (66.7%, n = 68) and infected-controls (71.3%, n = 87) tested positive for anti-N IgG. More cases tested positive for anti-Spike (94.1%, n = 96) and anti-RBD (95.1%, n = 97) IgG, as compared with controls (anti-Spike: 89.3%, n = 109; anti-RBD: 84.4%, n = 103). Similar trends were observed among unvaccinated participants. Effects of IgG titres on PCC status were non-significant in univariate and multivariate analyses. Adjusting for age and sex, PCC-cases were more likely to be efficient neutralizers (OR 2.2, 95% CI 1.11–4.49), and odds was further increased among cases to report deterioration in quality of life (OR 3.4, 95% CI 1.64–7.31). Clinical covariates found to be significantly related to PCC included obesity (OR 2.3, p = 0.02), number of months post COVID-19 (OR 1.1, p < 0.01), allergies (OR 1.8, p = 0.04), and need for medical support (OR 4.1, p < 0.01).ConclusionDespite past COVID-19 infection, approximately one third of PCC-cases and infected-controls were seronegative for anti-N IgG. Findings suggest higher neutralization efficiency among cases as compared with controls, and that this relationship is stronger among cases with more severe PCC. Cases also required more medical support for COVID-19 symptoms, and described complex, ongoing health sequelae. More data from larger cohorts are needed to substantiate results, permit subgroup analyses of IgG titres, and explore for differences between clusters of PCC symptoms. Future assessment of IgG subtypes may also elucidate new findings.

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IgG4 serum levels are not elevated in cases of Post-COVID syndrome

Cited by 2 publications

References 11 publications

Atopy and Elevation of IgE, IgG3, and IgG4 May Be Risk Factors for Post COVID-19 Condition in Children and Adolescents

Atopy and Elevation of IgE, IgG3, and IgG4 May Be Risk Factors for Post COVID-19 Condition in Children and Adolescents

Clinical and serological predictors of post COVID-19 condition–findings from a Canadian prospective cohort study

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