text: Long Term SARS CoV 2 Specific Immune and Inflammatory Responses Across a Clinically Diverse Cohort of Individuals Recovering from COVID 19 A detailed understanding of long term SARS CoV 2 specific T cell responses and their relationship to humoral immunity and markers of inflammation in diverse groups of individuals representing the spectrum of COVID 19 illness and recovery is urgently needed Data are also lacking as to whether and how adaptive immune and inflammatory responses differ in individuals that experience persistent symptomatic sequelae months following acute infection compared to those with complete rapid recovery We measured SARS CoV 2 specific T cell responses soluble markers of inflammation and antibody levels and neutralization capacity longitudinally up to 9 months following infection in a diverse group of 70 individuals with PCR confirmed SARS CoV 2 infection The participants had varying degrees of initial disease severity and were enrolled in the northern California Long term Impact of Infection with Novel Coronavirus LIINC cohort Adaptive T cell responses remained remarkably stable in all participants across disease severity during the entire study interval Whereas the magnitude of the early CD4 T cell immune response is determined by the severity of initial infection participants requiring hospitalization or intensive care pre existing lung disease was significantly associated with higher long term SARS CoV2 specific CD8 T cell responses independent of initial disease severity or age Neutralizing antibody levels were strongly correlated with SARS CoV 2 specific CD4 T but not CD8 T cell responses Importantly we did not identify substantial differences in long term virus specific T cell or antibody responses between participants with and without COVID 19 related symptoms that persist months after initial infection 