text: Long term SARS CoV 2 specific immune and inflammatory responses in individuals recovering from COVID 19 with and without post acute symptoms We describe severe acute respiratory syndrome coronavirus 2 SARS CoV 2 specific T cell responses soluble markers of inflammation and antibody levels and neutralization capacity longitudinally in 70 individuals with PCR confirmed SARS CoV 2 infection Participants represent a spectrum of illness and recovery including some with persistent viral shedding in saliva and many experiencing post acute sequelae of SARS CoV 2 infection PASC T cell responses remain stable for up to 9 months Whereas the magnitude of early CD4 sup sup T cell immune responses correlates with severity of initial infection pre existing lung disease is independently associated with higher long term SARS CoV 2 specific CD8 sup sup T cell responses Among participants with PASC 4 months following coronavirus disease 2019 COVID 19 symptom onset we observe a lower frequency of CD8 sup sup T cells expressing CD107a a marker of degranulation in response to Nucleocapsid N peptide pool stimulation and a more rapid decline in the frequency of N specific interferon γ producing CD8 sup sup T cells Neutralizing antibody levels strongly correlate with SARS CoV 2 specific CD4 sup sup T cell responses 