BioProject

There have been reports of long coronavirus disease (long COVID) and breakthrough infections (BTIs); however, the mechanisms and pathological features of long COVID after Omicron BTIs remain unclear. Assessing long COVID and immune recovery after Omicron BTIs is crucial for understanding the disease and developing and managing new-generation vaccines. Here, we followed up mild BA.2 BTI convalescents for six-month with routine blood tests and neutralization assay. Then, we applied proteomic analysis and single-cell RNA sequencing (scRNA-seq) to study the convalescents’ recovery status. Lastly, we retrospectively analyzed the clinical parameters related to immunity and metabolism of the convalescents. We found that major organs exhibited ephemeral dysfunction in double-Convidecia vaccinated persons who experienced BA.2 BTI and recovered to normal in approximately six-month. We observed durable and potent levels of neutralizing antibodies against major circulating severe acute respiratory syndrome coronavirus 2 sub-variants, including BQ.1, BQ.1.1 and BF.7, indicating that hybrid humoral immunity stays active. However, PLTs may take longer to recover. This was supported by proteomic and scRNA-seq analyses, which also showed coagulation disorder and an imbalance between anti-pathogen immunity and metabolism six-month after BA.2 BTI. The immunity-metabolism imbalance was then proved with retrospective analysis of abnormal levels of hormones, low blood glucose level and coagulation profile. The long-term malfunctional coagulation and imbalance in the material metabolism and immunity may contribute to the development of long COVID and act as useful indicators for assessing recovery and the long-term impacts after Omicron sub-variant BTIs. Overall design: We did single-cell RNA sequencing on 9 human samples, including 5 BA.2 breakthrough infected convalescents and 4 healthy people. >>>Raw data for human samples have been submitted to China's Genome Sequence Archive (GSA, https://ngdc.cncb.ac.cn/gsa/) with accession number HRA004484<<<