{
  "abstract": "Post-COVID-19 syndrome (PCS) is characterized by fatigue, neurological impairment and systemic symptoms. This heterogeneity of symptoms hinders biomarker development. Here, we profiled extracellular-vesicle (EV) surface markers in plasma and CSF from 61 participants with PCS (COVIDpost), 80 recovered controls (COVIDreco), and 10 participants with non-SARS-CoV-2 post-viral syndromes. EVs were analysed by bead-based multiplex flow cytometry using tetraspanin-directed (TSPN) and phosphatidylserine-directed lactadherin (PS) detection. Amongst 37 targets covering tetraspanins and vasculature-, immunity- and stemness-associated markers, none met a 1% false-discovery-rate threshold. However, L1-regularized logistic regression under fully nested 5x5 cross-validation identified a distributed plasma EV profile, with mean out-of-fold areas under the receiver operating characteristic curve (AUCs) of 0.788 (95% CI 0.715-0.852) for TSPN and 0.716 (95% CI 0.636-0.792) for PS detection. Across the pooled COVIDpost and COVIDreco population, EV classification scores covaried with clinical group differences, but did not track clinical severity within either cohort. These PCS-EV classification scores decreased at one-year follow-up in COVIDpost participants. Our findings identify an internally cross-validated multivariable EV surface profile associated with COVIDpost versus COVIDreco status and support independent validation and exploration of EV-based biomarkers in post-viral fatigue syndromes.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Molecular Virology, Ulm University Medical Center, Meyerhofstr. 1, 89081 Ulm, Germany"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "D. K. Erhart"
    },
    {
      "name": "H. Ressin"
    },
    {
      "name": "L. T. Balz"
    },
    {
      "name": "S. Chatterjee"
    },
    {
      "name": "D. Lule"
    },
    {
      "name": "S. Mueller"
    },
    {
      "name": "J. Lewerenz"
    },
    {
      "name": "J. Muench"
    },
    {
      "name": "H. Tumani"
    },
    {
      "affs": [
        0
      ],
      "name": "R. M. Gross"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7ryn0dbfypts0.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.27.26361498",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.27.26361498v1.full",
  "id": "7ryn0dbfypts0",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.27.26361498v1",
  "language": null,
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "neurology"
    ],
    [
      "openalex",
      "1312|Extracellular vesicles in disease"
    ]
  ],
  "openalex": "W7204768014",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.27.26361498v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-27",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7ryn0dbfypts0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:21Z",
      "native_id": "10.64898/2026.08.27.26361498",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.27.26361498v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:neurology",
      "subfield": "neurology"
    }
  ],
  "title": "A Multivariable Plasma Extracellular Vesicle Surface Profile Associated with Post-COVID-19 Syndrome",
  "title_text": "A Multivariable Plasma Extracellular Vesicle Surface Profile Associated with Post-COVID-19 Syndrome",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:21Z",
  "url": "https://research.draconitic.com/paper/7ryn0dbfypts0",
  "venue": "medRxiv",
  "versions": []
}