Immunological Density Shapes Recovery Trajectories in Long COVID

Fuente: arXiv
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Auteurs principaux: Wang, Jing, Zhang, Tong, Niu, Xing, Shen, Jie, Luo, Yiming, Xie, Qiaomin, Sra, Amar, Galis, Zorina, Weiss, Jeremy
Format: Preprint
Publié: 2026
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author Wang, Jing
Zhang, Tong
Niu, Xing
Shen, Jie
Luo, Yiming
Xie, Qiaomin
Sra, Amar
Galis, Zorina
Weiss, Jeremy
author_facet Wang, Jing
Zhang, Tong
Niu, Xing
Shen, Jie
Luo, Yiming
Xie, Qiaomin
Sra, Amar
Galis, Zorina
Weiss, Jeremy
contents Post-acute sequelae of SARS-CoV-2 infection (Long COVID) frequently persists for months, yet drivers of clinical remission remain incompletely defined. Here we analyzed 97,564 longitudinal PASC assessments from 13,511 participants with linked vaccination histories to disentangle passive temporal progression from vaccine-associated change. Using a clinically validated threshold (PASC $\geq 12$), trajectories separated into three phenotypes: Protected (persistently sub-threshold), Refractory (persistently symptomatic), and Responders (transitioning from symptomatic to recovered). Across the full cohort, symptom severity increased modestly with elapsed time ($r=0.0521$, $P=1.26\times10^{-59}$), whereas cumulative vaccination showed an inverse association with severity ($r=-0.0434$, $P=5.95\times10^{-42}$). In summary, baseline Long COVID severity appears clinically deterministic. In the absence of intervention, symptoms typically persist without spontaneous resolution. Recovery is primarily associated with repeated immunization.
format Preprint
id arxiv_https___arxiv_org_abs_2601_07854
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Immunological Density Shapes Recovery Trajectories in Long COVID
Wang, Jing
Zhang, Tong
Niu, Xing
Shen, Jie
Luo, Yiming
Xie, Qiaomin
Sra, Amar
Galis, Zorina
Weiss, Jeremy
Other Quantitative Biology
Artificial Intelligence
Post-acute sequelae of SARS-CoV-2 infection (Long COVID) frequently persists for months, yet drivers of clinical remission remain incompletely defined. Here we analyzed 97,564 longitudinal PASC assessments from 13,511 participants with linked vaccination histories to disentangle passive temporal progression from vaccine-associated change. Using a clinically validated threshold (PASC $\geq 12$), trajectories separated into three phenotypes: Protected (persistently sub-threshold), Refractory (persistently symptomatic), and Responders (transitioning from symptomatic to recovered). Across the full cohort, symptom severity increased modestly with elapsed time ($r=0.0521$, $P=1.26\times10^{-59}$), whereas cumulative vaccination showed an inverse association with severity ($r=-0.0434$, $P=5.95\times10^{-42}$). In summary, baseline Long COVID severity appears clinically deterministic. In the absence of intervention, symptoms typically persist without spontaneous resolution. Recovery is primarily associated with repeated immunization.
title Immunological Density Shapes Recovery Trajectories in Long COVID
topic Other Quantitative Biology
Artificial Intelligence
url https://arxiv.org/abs/2601.07854