Chapter 8 250 Association between early antibody titers and development of PASC Among participants with at least 3 months of follow-up after illness onset (n=316), no differences were observed in levels of anti-spike or anti-RBD binding IgG antibodies measured at 30-60 days after illness onset between those who developed PASC (n=186) and those who did not (n=130) (median difference in posterior means: 0.109 [95%CrI -0.101-0.343] and 0.093 [95%CrI -0.082-0.321], respectively) (Figure 2). Figure 2. IgG binding and spike neutralisation at 30–60 days following illness onset among all participants who did (N = 56) and did not (N = 72) develop PASC, by COVID-19 clinical severity Difference in 30–60 day WT-D614G spike protein neutralising IgG titers and anti-spike and antiRBD IgG binding titers between those who did and did not develop PASC. The mean effects on neutralising and IgG titers from those who did and did not develop PASC were estimated using a Bayesian multilevel model. Differences in posterior means were mean-centred such that effect sizes shown can be compared on a common scale (top row). Distributions of serum spike protein neutralising IgG titers (bottom left), spike binding (bottom middle) and RBD binding (bottom right) displayed such that each dot represents one participant, coloured according to COVID-19 clinical severity. RBD = Receptor binding domain. PASC = Post-acute sequelae of COVID-19. Levels of neutralising antibodies detected 30-60 days of illness onset were also comparable between those who developed PASC and those who did not (median difference in posterior means: 0.168 [95%CrI -0.05-0.395]). The stratified analysis was only performed in those who experienced mild and moderate COVID-19 as numbers in the severe/critical group were too low for a meaningful analysis. Results remained unchanged among those with moderate COVID-19 (Supplementary Figure S2). However, among participants with mild COVID-19, higher RBD-binding titers were observed among those who developed PASC
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