Blood antibody levels could clarify long COVID prognosis and memory problems

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by Okayama University

edited by Sadie Harley, reviewed by Andrew Zinin

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Researchers analyzed spike and nucleocapsid antibody levels in patients with long COVID and found that antibody patterns may help identify prior infection severity, cognitive symptoms such as brain fog and quality of life outcomes during the omicron era. Credit: Trinity Care Foundation from Openverse. https://openverse.org/image/37aed479-aae9-439f-a384-2e6a3b6b2a92?q=COVID+19+VIRUS&p=1

Persistent symptoms after COVID-19 infection continue to affect millions of people worldwide, even as the number of acute infections has declined. Long COVID (LC) can cause fatigue, headaches, sleep disturbances, breathing difficulties and cognitive problems commonly described as "brain fog."

Despite the growing burden of these lingering symptoms, clinicians still lack reliable biological markers that can objectively assess disease severity, predict prognosis or guide patient management. This challenge is especially important because many LC symptoms are subjective and difficult to quantify using conventional medical tests.

To address this, a research team led by Professor Fumio Otsuka from the Department of General Medicine, Okayama University Graduate School of Medicine, Japan, along with Assistant Professor Marina Kawaguchi and Dr. Yasue Sakurada from the Department of General Medicine, Okayama University Graduate School of Medicine, Japan, investigated whether blood levels of antibodies against the SARS-CoV-2 spike (S) and nucleocapsid (N) proteins could provide clinically meaningful information for understanding LC during the omicron era.

They analyzed data from 275 patients diagnosed with omicron variant-related LC who attended a specialized post-COVID outpatient clinic between July 2023 and November 2024. Their findings were published in the British Journal of Biomedical Science.

The team measured antibody levels and compared them with vaccination history, disease severity during acute infection, symptom profiles, laboratory findings and quality-of-life assessments.

Their analysis revealed that S-antibody levels were strongly associated with the number of vaccine doses received, whereas N-antibody levels reflected infection-related factors such as disease severity and the time elapsed since infection. Among unvaccinated patients, N-antibody levels steadily declined over time, decreasing by approximately 0.34% per day after infection.

The findings also showed that women tended to have higher N-antibody levels than men.

Perhaps the most clinically significant observation involved cognitive symptoms. Patients experiencing memory impairment—a common manifestation of brain fog—had significantly lower S-antibody levels than those without memory problems. Higher S-antibody levels were also associated with better self-reported quality of life.

Although antibody measurements alone were insufficient to fully predict cognitive symptoms, the results suggest that declining S-antibody levels may indicate a greater risk of neurological complications in LC.

"Objective biomarkers for LC remain limited, making patient evaluation particularly challenging. In the treatment of post-COVID-19 symptoms, viral antibody titers may help predict the history of COVID-19 infection during the omicron phase and may aid in the prognosis of post-COVID-19 symptoms, which are difficult to objectively determine," says Otsuka.

The study also demonstrated that N-antibody levels correlated positively with lymphocyte counts and immunoglobulin levels, further supporting their role as indicators of immune activity following infection. These insights may help clinicians interpret antibody test results more effectively in patients whose acute infection history is incomplete or poorly documented.

"Our findings suggest that antibody profiles may provide useful information about infection history, immune responses and symptom patterns, especially in patients experiencing cognitive difficulties. In future, we hope to combine viral antibody titers with clinical symptoms and other laboratory data to improve diagnosis and treatment strategies for LC," says Otsuka.

Overall, the findings indicate that SARS-CoV-2 antibody profiles may offer a practical tool for understanding LC during the omicron era.

By providing objective information about prior infection, immune responses and cognitive symptoms, antibody testing could contribute to more personalized care for patients living with persistent post-COVID conditions and support future efforts to develop evidence-based management strategies.

More information

Marina Kawaguchi et al, Clinical Utility of SARS-CoV-2 Antibody Titers in the Management of Patients With Long COVID Infected With the Omicron Variant, British Journal of Biomedical Science (2026). DOI: 10.3389/bjbs.2026.16255

Key medical concepts

Post-Acute COVID-19 SyndromeDeficit, Memory

Clinical categories

Infectious diseasesCommon illnesses & PreventionNeurology Provided by Okayama University Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

Citation: Blood antibody levels could clarify long COVID prognosis and memory problems (2026, June 12) retrieved 12 June 2026 from https://medicalxpress.com/news/2026-06-blood-antibody-covid-prognosis-memory.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.