{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T02:47:51Z","timestamp":1788058071780,"version":"build-2784847793"},"reference-count":84,"publisher":"American Society for Clinical Investigation","issue":"21","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":55,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of health\/National Institute of Allergy and Infectious Diseases","award":["5R01AI135803,5U19AI118608,3U01AI167892,5  U19 AI128910,4 U19AI090023,4 U19AI118610,R01 AI145835,5 U19AI062629,5 U19AI057229,5  U19  AI125357,5 U19AI128913,3U19AI077439,5 U54AI142766,5 R01AI104870,3U19AI089992,5R01AI132774,5T32DA018926,UM1TR004528"],"award-info":[{"award-number":["5R01AI135803,5U19AI118608,3U01AI167892,5  U19 AI128910,4 U19AI090023,4 U19AI118610,R01 AI145835,5 U19AI062629,5 U19AI057229,5  U19  AI125357,5 U19AI128913,3U19AI077439,5 U54AI142766,5 R01AI104870,3U19AI089992,5R01AI132774,5T32DA018926,UM1TR004528"]}]},{"name":"National Science Foundation","award":["DMS2310836"],"award-info":[{"award-number":["DMS2310836"]}]},{"name":"National Institutes of Health\/ National INstitute of Allergy and INfectious Diseases","award":["R01AI122220"],"award-info":[{"award-number":["R01AI122220"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Following SARS-CoV-2 infection, approximately 10%\u201335% of patients with COVID-19 experience long COVID (LC), in which debilitating symptoms persist for at least 3 months. Elucidating the biologic underpinnings of LC could identify therapeutic opportunities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We utilized machine learning methods on biologic analytes provided over 12 months after hospital discharge from more than 500 patients with COVID-19 in the IMPACC cohort to identify a multiomics \u201crecovery factor,\u201d trained on patient-reported physical function survey scores. Immune profiling data included PBMC transcriptomics, serum O-link and plasma proteomics, plasma metabolomics, and blood mass cytometry by time of flight (CyTOF) protein levels. Recovery factor scores were tested for association with LC, disease severity, clinical parameters, and immune subset frequencies. Enrichment analyses identified biologic pathways associated with recovery factor scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Participants with LC had lower recovery factor scores compared with recovered participants. Recovery factor scores predicted LC as early as hospital admission, irrespective of acute COVID-19 severity. Biologic characterization revealed increased inflammatory mediators, elevated signatures of heme metabolism, and decreased androgenic steroids as predictive and ongoing biomarkers of LC. Lower recovery factor scores were associated with reduced lymphocyte and increased myeloid cell frequencies. The observed signatures are consistent with persistent inflammation driving anemia and stress erythropoiesis as major biologic underpinnings of LC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The multiomics recovery factor identifies patients at risk of LC early after SARS-CoV-2 infection and reveals LC biomarkers and potential treatment targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT04378777.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>FUNDING<\/jats:title>\n                    <jats:p>National Institute of Allergy and Infectious Diseases (NIAID), NIH (3U01AI167892-03S2, 3U01AI167892-01S2, 5R01AI135803-03, 5U19AI118608-04, 5U19AI128910-04, 4U19AI090023-11, 4U19AI118610-06, R01AI145835-01A1S1, 5U19AI062629-17, 5U19AI057229-17, 5U19AI057229-18, 5U19AI125357-05, 5U19AI128913-03, 3U19AI077439-13, 5U54AI142766-03, 5R01AI104870-07S1, 3U19AI089992-09, 3U19AI128913-03, and 5T32DA018926-1, 3U19AI1289130, U19AI128913-04S1, R01AI122220); NIH (UM1TR004528); and National Science Foundation (NSF) (DMS2310836).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1172\/jci193698","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T16:01:11Z","timestamp":1757433671000},"source":"Crossref","is-referenced-by-count":9,"title":["A multiomics recovery factor predicts long COVID in the IMPACC study"],"prefix":"10.1172","volume":"135","author":[{"given":"Gisela","family":"Gabernet","sequence":"first","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut, 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