text: Duration of post COVID 19 symptoms is associated with sustained SARS CoV 2 specific immune responses A subset of COVID 19 patients exhibit post acute sequelae of COVID 19 PASC but little is known about the immune signatures associated with these syndromes We investigated longitudinal peripheral blood samples in 50 individuals with previously confirmed SARS CoV 2 infection including 20 who experienced prolonged duration of COVID 19 symptoms lasting more than 30 days median 74 days compared with 30 who had symptom resolution within 20 days Individuals with prolonged symptom duration maintained antigen specific T cell response magnitudes to SARS CoV 2 spike protein in CD4 and circulating T follicular helper cell populations during late convalescence while those without persistent symptoms demonstrated an expected decline The prolonged group also displayed increased IgG avidity to SARS CoV 2 spike protein Significant correlations between symptom duration and both SARS CoV 2 specific T cells and antibodies were observed Activation and exhaustion markers were evaluated in multiple immune cell types revealing few phenotypic differences between prolonged and recovered groups suggesting that prolonged symptom duration is not due to persistent systemic inflammation These findings demonstrate that SARS CoV 2 specific immune responses are maintained in patients suffering from prolonged post COVID 19 symptom duration in contrast to those with resolved symptoms and may suggest the persistence of viral antigens as an underlying etiology 