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Zoe Swank, PhD



Job Title

Postdoctoral Research Fellow

Academic Rank

Research Fellow




Zoe Swank, Yasmeen Senussi, Zachary Manickas-Hill, Xu G. Yu, Jonathan Z. Li, Galit Alter, David R. Walt

Principal Investigator

David R. Walt

Research Category: COVID-19


Persistent circulating SARS-CoV-2 spike is associated with post-acute COVID-19 sequelae

Scientific Abstract

The diagnosis and management of post-acute sequelae of COVID-19 (PASC) poses an ongoing medical challenge. Identifying biomarkers associated with PASC would immensely improve the classification of PASC patients and provide the means to evaluate treatment strategies. We analyzed plasma samples collected from a cohort of PASC and COVID-19 patients (n = 63) to quantify circulating viral antigens and inflammatory markers. Strikingly, we detect SARS-CoV-2 spike antigen in a majority of PASC patients up to 12 months post-diagnosis, suggesting the presence of an active persistent SARS-CoV-2 viral reservoir. Furthermore, temporal 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.

Lay Abstract

While symptoms resulting from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically resolve within a few weeks, some individuals experience persistent symptoms following the acute phase of coronavirus disease (COVID-19). The associated syndrome, termed post-acute sequelae of COVID-19 (PASC) or long COVID, encompasses a range of symptoms, affecting multiple organs. Although recent studies provide clues, the underlying causes of long COVID are not well understood. As long COVID symptoms are heterogeneous, a specific diagnostic test would greatly improve the classification of long COVID patients. We recently discovered that many patients diagnosed with long COVID have SARS-CoV-2 spike protein in their blood up to 12 months post-infection. If this trend is validated in a larger number of patients, then testing for spike could greatly aid the diagnosis of long COVID. Furthermore, if the presence of spike is linked with an ongoing infection, patients treated with anti-viral therapies could be monitored and a decrease in spike levels would be expected to correlate with effective treatment strategies.

Clinical Implications

Diagnosing long COVID is not trivial as patients present with a wide range of symptoms that overlap with other conditions. A biomarker specific to long COVID would improve patient classification and enable the evaluation of new treatment strategies.