{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:26:00Z","timestamp":1787793960639,"version":"build-2784847793"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006962","name":"NYU Langone Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006962","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The SARS-CoV-2 virus resulted in significant disability and diagnostic challenges among patients with Post-Acute Sequelae of COVID-19 (PASC). Here, we assessed microvascular perfusion, clotting, and autoimmune responses to lung targets in PASC patients compared to healthy controls with the aim of explaining the persistent respiratory symptoms of patients with PASC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a blinded case-control study of 20 PASC patients with persistent respiratory symptoms versus 20 healthy controls previously infected with SARS-CoV-2 virus. We assessed lung perfusion using Technetium-99m macroaggregated albumin (MAA) SPECT-CT scans, clotting using coagulation and thromboelastrogram (TEG) tests, and autoimmunity to vascular and lung antigens using ELISA assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Subjective respiratory symptoms and quality-of-life measures were significantly worse among the PASC patients compared with healthy controls (p&amp;lt;0.001). Clinical symptoms among PASC patients were inversely correlated with plasma total IgA levels (coefficient: -0.61, p=0.004) and with autoimmune IgA recognizing pulmonary microvascular endothelial cell antigens (coefficient: -0.51, p=0.02). Additionally, levels of total IgA were directly correlated with fibrinogen and fibrin-related clot strength (coefficient: +0.52, p=0.02; coefficient: +0.63, p=0.003). SPECT-CT scans were positive only among 25% of PASC cases versus 10% of healthy controls (p=0.41). TEG tests showed no differences between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our small study of PASC patients identified that circulating IgA antibodies may correlate inversely with clinical symptoms and directly with clotting parameters, suggesting a possible link between autoimmunity and coagulation. However, many of the study\u2019s findings were null, which may mean that tissue-level studies or alternative explanations of PASC need to be explored.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1589559","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:44:08Z","timestamp":1748583848000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["IgA autoimmunity and coagulation among post-acute sequelae of SARS-CoV-2 infection (PASC) patients with persistent respiratory symptoms: a case-control study"],"prefix":"10.3389","volume":"16","author":[{"given":"Claudia","family":"Gomes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan 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