Abstract Details

Title The LCCS Study (Long COVID Cutaneous Signatures): An ARPA Funded Research Project

Topic Infectious Disease

Presentation(s) S22 - Neuroinfectious Disease: Basic Sciences (1:48 PM-2:00 PM)

Poster/Presentation
Number 005

Objective Define neuropathological changes in the peripheral nervous system in patients with post-acute sequelae of SARS-CoV-19 (PASC) and compare these to a healthy and disease control population.

Background PASC, also known as Long COVID, has impacted global, national, and state health systems. 1 in 5 people with COVID experience prolonged symptoms, and the prevalence increases to 1 in 4 over the age of 65. Many symptoms are hypothesized to be a consequence of damage to the sensory or autonomic nervous systems. The pathophysiology of these patients is not well understood.

Design/Methods There are 4 cohorts in this single-center study: 1) PASC defined by NIH criteria; 2) post-COVID without persistent symptoms defined by WHO criteria; Disease controls (Covid-recovered), 3) postural orthostatic tachycardia syndrome (POTS), and 4) diabetic peripheral neuropathy (DPN). After informed consent, physical and neurological examinations are completed with skin biopsies taken from three regions, and immunostained for sensory (IENFD), sympathetic cholinergic (SGNFD), and sympathetic adrenergic (PMNFD) fibers. Phosphorylated alpha-synuclein (P-SYN) was measured. Medical history, orthostatic vital signs, and questionnaires were obtained.

Results In an interim analysis, 148 subjects were enrolled. A total of 42 COVID-recovered (age 47.1±16.5 years, 36% Female), 5 DPN (53.2±7.1 years, 40% Female), 80 PASC (46.3±14.0 years, 67% Female), and 21 POTS (35.1±9.5 years, 100% Female). There were no significant differences in SGNFD, PMNFD, or IENFD between the PASC and Covid-recovered groups. Individuals with DPN had significantly lower IENFD values at the distal leg (P<0.05 vs other groups). P-SYN was detected in 4% of cases, with no differences between groups.

Conclusions

There was no evidence of peripheral unmyelinated nociceptive c-fiber or autonomic nerve fiber injury in patients with PASC compared to age-matched individuals who have recovered from COVID without long-term sequelae. Symptoms of PASC are not accompanied by evidence of peripheral nerve injury in this study.

Authors/Disclosures
Todd D. Levine, MD (Honor Health) PRESENTER	Dr. Levine has received personal compensation for serving as an employee of CND life sciences . Dr. Levine has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Nufactor. Dr. Levine has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for PNA. Dr. Levine has or had stock in CND Life Sciences.Dr. Levine has or had stock in Corinthian reference lab.
Bailey Bellaire (CND Life Sciences)	Bailey Bellaire has received personal compensation for serving as an employee of CND Life Sciences.
Sarrah Marcotte	Miss Marcotte has received personal compensation for serving as an employee of CND Life Sciences.
Jourdan Parent, PhD	Dr. Parent has received personal compensation for serving as an employee of CND Life Sciences.
Manuel X. Duval, PhD	Mr. Duval has received personal compensation for serving as an employee of CND Life sciences.
Roy L. Freeman, MD (Beth Israel Deaconess Hosp)	Dr. Freeman has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Cutaneous Diagnostic Life Sciences. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vertex. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Theravance. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Inhibikase. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Freeman has received research support from NIH. The institution of Dr. Freeman has received research support from Theravance. The institution of Dr. Freeman has received research support from Biohaven. The institution of Dr. Freeman has received research support from Lundbeck. Dr. Freeman has received research support from Regeneron.
Christopher H. Gibbons, MD, FAAN (Beth Israel Deaconess Medical Center)	Dr. Gibbons has received personal compensation for serving as an employee of CND Life Sciences. Dr. Gibbons has or had stock in CND Life Sciences.Dr. Gibbons has received publishing royalties from a publication relating to health care.

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