{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:01:49Z","timestamp":1787738509870,"version":"build-2784847793"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 AI171263"],"award-info":[{"award-number":["K23 AI171263"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24 AI155230"],"award-info":[{"award-number":["K24 AI155230"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postacute sequelae of COVID-19 (PASC), also known as long COVID, and postacute COVID-19 vaccination syndrome (PACVS) present overlapping but distinct clinical challenges. We hypothesize that PASC and PACVS share clinical features but differ in symptom patterns and biomarker profiles. This study aims to identify differences in presentation and distinguish immunologic biomarkers relevant to general clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study analyzed 181 patients from a PASC clinic at Columbia University Irving Medical Center. Patients were divided into PASC with myalgic encephalomyelitis\/chronic fatigue syndrome (MECFS), PASC without MECFS (LC), and PACVS groups. Prevalence and severity of self-reported symptoms, as well as immunologic abnormalities, were compared across groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fatigue was the most common symptom (Total: 88.95%; MECFS: 100.00%; PACVS: 92.86%; LC: 78.05%). The MECFS group generally reported more symptoms across all organ systems. The PACVS group reported higher rates of atypical chief complaints such as peripheral neuropathy (17.9%), tinnitus (7.1%), and rash (10.7%) compared to the other groups (P = &amp;lt;.01). Functional impairment was comparable between the MECFS and PACVS groups and less severe in the LC group. All groups had high rates of autoantibody positivity and cytokine elevation. The PACVS group showed significantly higher rates of anticardiolipin IgM (PACVS 42.9%, LC 11.6%; P = .02) and anti-U1-RNP (PACVS 21.4%, LC 2.3%; P = .04) positivity compared to the LC group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PASC and PACVS share symptom overlap but exhibit distinct biomarker patterns, particularly elevated autoantibody levels in PACVS. These findings suggest autoimmune involvement, warranting further investigation for targeted therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf624","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:56:32Z","timestamp":1765976192000},"page":"e923-e931","source":"Crossref","is-referenced-by-count":2,"title":["Overlapping Clinical Presentation of Long COVID and Postacute COVID-19 Vaccination Syndrome: Phenotypes, Severity, and Biomarkers"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2900-6022","authenticated-orcid":false,"given":"Lawrence","family":"Purpura","sequence":"first","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]},{"name":"New York Presbyterian Hospital , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Heisler","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]},{"name":"Department of Medicine, University of California Davis Medical Center , Sacramento, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayesh","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7107-5654","authenticated-orcid":false,"given":"Abigail","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7080-1766","authenticated-orcid":false,"given":"Ga Young","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Sturiza","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiomara","family":"Javier","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giselle","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Rosa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3772-5025","authenticated-orcid":false,"given":"Joan","family":"Bosco","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9509-4526","authenticated-orcid":false,"given":"Karl","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7112-3118","authenticated-orcid":false,"given":"Magdalena E","family":"Sobieszczyk","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]},{"name":"New York Presbyterian Hospital , New York, NY ,","place":["USA"]},{"name":"Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-9056","authenticated-orcid":false,"given":"Michael T","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]},{"name":"New York Presbyterian Hospital , New York, NY ,","place":["USA"]},{"name":"Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"2026052019221858500_ciaf624-B1","volume-title":"A long COVID definition: a chronic, systemic disease state with profound consequences","author":"National Academies of Sciences, Engineering, and Medicine","year":"2024"},{"key":"2026052019221858500_ciaf624-B2","doi-asserted-by":"crossref","first-page":"5500","DOI":"10.1016\/j.cell.2024.07.054","article-title":"Mechanisms of long COVID and the path toward therapeutics","volume":"187","author":"Peluso","year":"2024","journal-title":"Cell"},{"key":"2026052019221858500_ciaf624-B3","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s11606-024-09290-9","article-title":"Incidence and prevalence of post-COVID-19 myalgic encephalomyelitis: a report from the observational RECOVER-adult study","volume":"40","author":"Vernon","year":"2025","journal-title":"J Gen Intern Med"},{"key":"2026052019221858500_ciaf624-B4","doi-asserted-by":"crossref","first-page":"790","DOI":"10.3390\/vaccines12070790","article-title":"Clinical and diagnostic features of post-acute COVID-19 vaccination syndrome (PACVS)","volume":"12","author":"Mundorf","year":"2024","journal-title":"Vaccines (Basel)"},{"key":"2026052019221858500_ciaf624-B5","doi-asserted-by":"crossref","first-page":"4673","DOI":"10.1007\/s00415-023-11895-9","article-title":"Neurological symptoms after COVID-19 vaccination: a report on the clinical presentation of the first 50 patients","volume":"270","author":"Gerhard","year":"2023","journal-title":"J Neurol"},{"key":"2026052019221858500_ciaf624-B6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s12026-024-09553-x","article-title":"SARS-CoV-2 pathophysiology and post-vaccination severity: a systematic review","volume":"73","author":"Rustagi","year":"2024","journal-title":"Immunol Res"},{"key":"2026052019221858500_ciaf624-B7","doi-asserted-by":"crossref","first-page":"1398028","DOI":"10.3389\/fimmu.2024.1398028","article-title":"Post-SARS-CoV-2 infection and post-vaccine-related neurological complications share clinical features and the same positivity to anti-ACE2 antibodies","volume":"15","author":"Bellucci","year":"2024","journal-title":"Front Immunol"},{"key":"2026052019221858500_ciaf624-B8","doi-asserted-by":"crossref","first-page":"1404800","DOI":"10.3389\/fimmu.2024.1404800","article-title":"High serum prevalence of autoreactive IgG antibodies against peripheral nerve structures in patients with neurological post-COVID-19 vaccination syndrome","volume":"15","author":"Arlt","year":"2024","journal-title":"Front Immunol"},{"key":"2026052019221858500_ciaf624-B9","doi-asserted-by":"crossref","first-page":"103445","DOI":"10.1016\/j.autrev.2023.103445","article-title":"Severity of neurological Long-COVID symptoms correlates with increased level of autoantibodies targeting vasoregulatory and autonomic nervous system receptors","volume":"22","author":"Seibert","year":"2023","journal-title":"Autoimmun Rev"},{"key":"2026052019221858500_ciaf624-B10","doi-asserted-by":"publisher","author":"Santos Guedes de Sa","DOI":"10.1101\/2024.06.18.24309100"},{"key":"2026052019221858500_ciaf624-B11","doi-asserted-by":"crossref","first-page":"e29864","DOI":"10.1002\/jmv.29864","article-title":"From human herpes virus-6 reactivation to autoimmune reactivity against tight junctions and neuronal antigens, to inflammation, depression, and chronic fatigue syndrome due to Long COVID","volume":"96","author":"Maes","year":"2024","journal-title":"J Med Virol"},{"key":"2026052019221858500_ciaf624-B12","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.jare.2024.11.011","article-title":"Brain-targeted autoimmunity is strongly associated with Long COVID and its chronic fatigue syndrome as well as its affective symptoms","volume":"75","author":"Almulla","year":"2024","journal-title":"J Adv Res"},{"key":"2026052019221858500_ciaf624-B13","doi-asserted-by":"crossref","first-page":"1482917","DOI":"10.3389\/fneur.2024.1482917","article-title":"Overlapping conditions in Long COVID at a multisite academic center","volume":"15","author":"Grach","year":"2024","journal-title":"Front Neurol"},{"key":"2026052019221858500_ciaf624-B14","doi-asserted-by":"crossref","first-page":"21501319241258671","DOI":"10.1177\/21501319241258671","article-title":"Longitudinal progression of patients with long COVID treated in a post-COVID clinic: a cross-sectional survey","volume":"15","author":"Hurt","year":"2024","journal-title":"J Prim Care Community Health"},{"key":"2026052019221858500_ciaf624-B15","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/ana.27128","article-title":"Neurologic manifestations of long COVID disproportionately affect young and middle-age adults","volume":"97","author":"Choudhury","year":"2024","journal-title":"Ann Neurol"},{"key":"2026052019221858500_ciaf624-B16","doi-asserted-by":"crossref","first-page":"e250","DOI":"10.1093\/cid\/ciac724","article-title":"Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19 (September 2022)","volume":"78","author":"Bhimraj","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2026052019221858500_ciaf624-B17","volume-title":"Beyond myalgic encephalomyelitis\/chronic fatigue syndrome: redefining an illness","author":"Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome","year":"2015"},{"key":"2026052019221858500_ciaf624-B18","volume-title":"Long-term health effects of COVID-19: disability and function following SARS-CoV-2 infection","author":"National Academies of Sciences, Engineering, and Medicine","year":"2024"},{"key":"2026052019221858500_ciaf624-B19","doi-asserted-by":"crossref","first-page":"28617","DOI":"10.1038\/s41598-024-75920-1","article-title":"Altered leukocyte pattern and inflammatory markers in unvaccinated long COVID patients: a cross-sectional study","volume":"14","author":"Chaves","year":"2024","journal-title":"Sci Rep"},{"key":"2026052019221858500_ciaf624-B20","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.ijid.2020.09.016","article-title":"COVID-19 hyperinflammation and post-COVID-19 illness may be rooted in mast cell activation syndrome","volume":"100","author":"Afrin","year":"2020","journal-title":"Int J Infect Dis"},{"key":"2026052019221858500_ciaf624-B21","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ijid.2021.09.043","article-title":"Mast cell activation symptoms are prevalent in Long-COVID","volume":"112","author":"Weinstock","year":"2021","journal-title":"Int J Infect Dis"},{"key":"2026052019221858500_ciaf624-B22","first-page":"e37","article-title":"Maintaining safety with SARS-CoV-2 vaccines","volume":"384","author":"Rolla","year":"2021","journal-title":"N Engl J Med"},{"key":"2026052019221858500_ciaf624-B23","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1016\/j.jaci.2021.04.002","article-title":"Potential mechanisms of anaphylaxis to COVID-19 mRNA vaccines","volume":"147","author":"Risma","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"2026052019221858500_ciaf624-B24","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/00005537-199702000-00015","article-title":"Comparison of anti-heat shock protein 70 (anti-hsp70) and anti-68-kDa inner ear protein in the sera of patients with Meniere's disease","volume":"107","author":"Shin","year":"1997","journal-title":"Laryngoscope"},{"key":"2026052019221858500_ciaf624-B25","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.cca.2007.02.045","article-title":"Comparison of immune assays for the detection of anti-HSP70 antibodies in patients with idiopathic sensorineural hearing loss","volume":"381","author":"Tebo","year":"2007","journal-title":"Clinica Chimica Acta"},{"key":"2026052019221858500_ciaf624-B26","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s12192-014-0507-6","article-title":"Evidence for a role of autoantibodies to heat shock protein 60, 70, and 90 in patients with dermatitis herpetiformis","volume":"19","author":"Kasperkiewicz","year":"2014","journal-title":"Cell Stress Chaperones"},{"key":"2026052019221858500_ciaf624-B27","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jsbmb.2016.10.002","article-title":"Autoimmunity to heat shock proteins and vitamin D status in patients with celiac disease without associated dermatitis herpetiformis","volume":"173","author":"Tukaj","year":"2017","journal-title":"J Steroid Biochem Mol Biol"},{"key":"2026052019221858500_ciaf624-B28","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s12192-018-0951-9","article-title":"Autoantibodies to heat shock proteins 60, 70, and 90 in patients with rheumatoid arthritis","volume":"24","author":"Mantej","year":"2019","journal-title":"Cell Stress Chaperones"},{"key":"2026052019221858500_ciaf624-B29","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1161\/hc0802.103729","article-title":"Heat shock proteins, inflammation, and cardiovascular disease","volume":"105","author":"Pockley","year":"2002","journal-title":"Circulation"},{"key":"2026052019221858500_ciaf624-B30","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/000348940611500314","article-title":"Western blot immunoassay for HSP-70 antibodies in idiopathic tinnitus: a preliminary report","volume":"115","author":"Savastano","year":"2006","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"2026052019221858500_ciaf624-B31","first-page":"285","article-title":"Cogan's syndrome: anti-Hsp70 antibodies are a serological marker in the typical form","volume":"16","author":"Bonaguri","year":"2014","journal-title":"Isr Med Assoc J"},{"key":"2026052019221858500_ciaf624-B32","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1055\/s-0038-1648840","article-title":"Prevalence, follow-up and clinical significance of the anticardiolipin antibodies in normal subjects","volume":"72","author":"Vila","year":"1994","journal-title":"Thromb Haemost"},{"key":"2026052019221858500_ciaf624-B33","doi-asserted-by":"crossref","first-page":"8380214","DOI":"10.1155\/2019\/8380214","article-title":"Advances in the research on anticardiolipin antibody","volume":"2019","author":"Wang","year":"2019","journal-title":"J Immunol Res"},{"key":"2026052019221858500_ciaf624-B34","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/s12985-023-02191-z","article-title":"Prevalence, clinical significance, and persistence of autoantibodies in COVID-19","volume":"20","author":"Lee","year":"2023","journal-title":"Virol J"},{"key":"2026052019221858500_ciaf624-B35","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ijid.2021.09.079","article-title":"Persistent IgG anticardiolipin autoantibodies are associated with post-COVID syndrome","volume":"113","author":"Bertin","year":"2021","journal-title":"Int J Infect Dis"},{"key":"2026052019221858500_ciaf624-B36","doi-asserted-by":"crossref","first-page":"109845","DOI":"10.1016\/j.clim.2023.109845","article-title":"Antiphospholipid antibodies are enriched post-acute COVID-19 but do not modulate the thrombotic risk","volume":"257","author":"Emmenegger","year":"2023","journal-title":"Clin Immunol"},{"key":"2026052019221858500_ciaf624-B37","doi-asserted-by":"crossref","first-page":"A404","DOI":"10.1016\/j.autrev.2011.12.001","article-title":"Igm predominance in autoimmune disease: genetics and gender","volume":"11","author":"Duarte-Rey","year":"2012","journal-title":"Autoimmun Rev"},{"key":"2026052019221858500_ciaf624-B38","doi-asserted-by":"crossref","first-page":"3229","DOI":"10.1182\/blood-2005-07-2650","article-title":"U1 small nuclear ribonucleoprotein immune complexes induce type I interferon in plasmacytoid dendritic cells through TLR7","volume":"107","author":"Savarese","year":"2006","journal-title":"Blood"},{"key":"2026052019221858500_ciaf624-B39","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/art.40672","article-title":"Macrophage migration inhibitory factor regulates U1 small nuclear RNP immune complex-mediated activation of the NLRP3 inflammasome","volume":"71","author":"Shin","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"2026052019221858500_ciaf624-B40","first-page":"2200970","article-title":"Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long COVID symptoms","volume":"61","author":"Son","year":"2023","journal-title":"Eur Respir J"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf624\/66320801\/ciaf624.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/5\/e923\/66320801\/ciaf624.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/5\/e923\/66320801\/ciaf624.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T23:22:28Z","timestamp":1779319348000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/82\/5\/e923\/8417802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,9]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,1,9]]},"published-print":{"date-parts":[[2026,5,20]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf624","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,15]]},"published":{"date-parts":[[2026,1,9]]}}}