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Little is known about the sustained impact of acute severe COVID\u201019 on immune signatures and long\/post\u2010COVID symptoms, often associated with cardiovascular events and pulmonary impairment. The longitudinal cohort (LC) was obtained from\n                    <jats:italic>N<\/jats:italic>\n                    = 46 patients with previous severe COVID\u201019 and prior to SARS\u2010CoV\u20102 vaccination, collected over 5 visits up to 12 months after discharge (\n                    <jats:italic>n<\/jats:italic>\n                    = 139). Long\/post\u2010COVID status was assessed by lung function and fatigue scores. Blood was analysed regarding immune cell profiles, SARS\u2010CoV\u20102 antibodies, and autoantigens. LC patients were compared with 39 acute severe COVID\u201019 ICU patients and 28 unexposed pre\u2010pandemic donors (UE) and correlated with clinical parameters. LC patients exhibited long\u2010term decreased CD4\n                    <jats:sup>+<\/jats:sup>\n                    \/CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cell ratio, differentiation from na\u00efve to TEMRA, CD57\n                    <jats:sup>+<\/jats:sup>\n                    CCR7\n                    <jats:sup>\u2212<\/jats:sup>\n                    memory, and HLA\u2010DR\n                    <jats:sup>+<\/jats:sup>\n                    CD38\n                    <jats:sup>+<\/jats:sup>\n                    activated CD4\n                    <jats:sup>+<\/jats:sup>\n                    and CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells. LC plasma profiles displayed elevated levels of markers for chronic inflammation and endothelial injury. Chronic inflammatory chemokines and cardiovascular markers remained high. These markers and autoantibodies against centromere structures negatively correlated with lung function. At 1\u2010year post\u2010discharge, LC patients with a COVID\u201019 ICU history displayed sustained significant changes in their immune profile at cellular and inflammatory levels, revealing signatures of persistent inflammation and endothelial injury.\n                  <\/jats:p>","DOI":"10.1002\/eji.70169","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T06:38:40Z","timestamp":1774852720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post\u2010Acute Sequelae Patients with Severe COVID\u201019 History Show a Prolonged Inflammatory, Vascular Injury Pattern"],"prefix":"10.1002","volume":"56","author":[{"given":"Louisa","family":"Ruhl","sequence":"first","affiliation":[{"name":"Institute of Transplant Immunology Hannover Medical School  Hannover 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