# Long COVID is associated with female sex; Anti-NCAM1 autoantibodies are absent in patients with long COVID

**Authors:** Yukiko Motokawa, Jun Sugihara, Tomoya Tateishi, Tadashi Hosoya, Shinsuke Yasuda, Yasunari Miyazaki, Hidehiko Takahashi, Hiroki Shiwaku

PMC · DOI: 10.1016/j.ibneur.2025.07.002 · 2025-07-09

## TL;DR

This study found that long COVID is more common in women, but no anti-NCAM1 autoantibodies were detected in patients with long COVID.

## Contribution

The study provides new evidence that anti-NCAM1 autoantibodies are not produced in long COVID patients.

## Key findings

- No anti-NCAM1 autoantibodies were detected in any of the 173 serum samples.
- Female sex was significantly associated with a higher risk of long COVID.

## Abstract

Long COVID is a condition that may arise following SARS-CoV-2 infection and is associated with a range of systemic complications. Autoantibodies are implicated in the pathogenesis of long COVID. However, the details of the pathogenic mechanisms undergone by these autoantibodies remain unclear. Neural cell adhesion molecule 1 (NCAM1) is the human protein with the highest sequence homology to the SARS-CoV-2 proteins. Previous in silico studies indicate that SARS-CoV-2 infection may induce the production of anti-NCAM1 autoantibodies. Thus, this study investigated the presence of anti-NCAM1 autoantibodies in individuals affected by COVID-19, including those with long COVID.

Serum samples were obtained from 173 individuals 3 months after SARS-CoV-2 infection. Among them, 63 were diagnosed with long COVID. A cell-based assay was used to assess all 173 serum samples for the presence of anti-NCAM1 autoantibodies. We also analyzed the clinical profiles of patients with and without long COVID to identify potential risk factors associated with long COVID.

Anti-NCAM1 autoantibodies were not detected in any serum sample. The proportion of female patients in the long COVID group was significantly higher than that in the non-long COVID group.

The results indicate that the production of anti-NCAM1 autoantibodies following COVID-19 is unlikely. Female sex is associated with higher risk of long COVID.

## Linked entities

- **Proteins:** NCAM1 (neural cell adhesion molecule 1)
- **Diseases:** COVID-19 (MONDO:0100096)

## Full-text entities

- **Genes:** NCAM1 (neural cell adhesion molecule 1) [NCBI Gene 4684] {aka CD56, MSK39, NCAM}
- **Diseases:** COVID-19 (MESH:D000086382), Long COVID (MESH:D000094024)
- **Species:** Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12275955/full.md

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Source: https://tomesphere.com/paper/PMC12275955