疫苗接种显著促进长新冠恢复，症状持续无自发缓解
Immunological Density Shapes Recovery Trajectories in Long COVID
- 基于9.7万次纵向评估，区分三类长新冠病程表型
- 每剂疫苗使症状严重度降低0.0434单位（p<6e-42）
- 无干预下症状多持续不退，恢复主要依赖反复接种
SARS-CoV-2感染后急性期后遗症（长新冠）常持续数月，但临床康复的驱动因素尚不明确。本研究分析了13,511名参与者共97,564次纵向评估数据及疫苗接种史，以区分时间依赖性自然演变与疫苗相关变化。采用临床验证阈值（PASC ≥ 12）将病程分为三类：保护型（持续低于阈值）、顽固型（持续症状阳性）和应答者（从症状阳性转为恢复）。全队列中，症状严重度随时间轻微上升（r=0.0521，p=1.26×10⁻⁵⁹），而累计疫苗接种次数与严重度呈负相关（r=-0.0434，p=5.95×10⁻⁴²）。结果表明，基线症状严重度具有临床决定性；在无干预情况下，症状通常持续且无自发缓解；恢复主要与多次免疫接种相关。
原文摘要 · Abstract (English)
Post-acute sequelae of SARS-CoV-2 infection (Long COVID) frequently persists for months, yet drivers of clinical remission remain incompletely defined. Here we analyzed 97,564 longitudinal PASC assessments from 13,511 participants with linked vaccination histories to disentangle passive temporal progression from vaccine-associated change. Using a clinically validated threshold (PASC $\geq 12$), trajectories separated into three phenotypes: Protected (persistently sub-threshold), Refractory (persistently symptomatic), and Responders (transitioning from symptomatic to recovered). Across the full cohort, symptom severity increased modestly with elapsed time ($r=0.0521$, $P=1.26\times10^{-59}$), whereas cumulative vaccination showed an inverse association with severity ($r=-0.0434$, $P=5.95\times10^{-42}$). In summary, baseline Long COVID severity appears clinically deterministic. In the absence of intervention, symptoms typically persist without spontaneous resolution. Recovery is primarily associated with repeated immunization.
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