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Alterations in T and B cell function persist in convalescent COVID-19 patients

2021; Elsevier BV; Volume: 2; Issue: 6 Linguagem: Inglês

10.1016/j.medj.2021.03.013

2666-6359

Halima Ali Shuwa, Tovah N. Shaw, Sean Knight, Kelly Wemyss, Flora A. McClure, Laurence Pearmain, Ian Prise, Christopher Jagger, David J. W. Morgan, Saba Khan, Stephan Brand, Elizabeth R. Mann, Andrew Ustianowski, Nawar Diar Bakerly, Paul Dark, Christopher E. Brightling, Seema Brij, Timothy Felton, Angela Simpson, John R. Grainger, Tracy Hussell, Joanne E. Konkel, Madhvi Menon, Rohan Ahmed, Miriam Avery, Katharine Birchall, Evelyn Charsley, Alistair Chenery, Christine Chew, Richard Clark, Emma Connolly, Karen Connolly, Simon Dawson, Laura Jayne Durrans, Hannah Durrington, Jasmine Egan, Kara J. Filbey, Julie Fox, Helen Francis, Miriam Franklin, Susannah Glasgow, Nicola J. Godfrey, Kathryn J. Gray, Seamus Grundy, Jacinta Guerin, Pamela Hackney, C. G. Hayes, Emma Hardy, Jade Harris, Anu John, Bethany Jolly, Verena Kästele, Gina Kerry, Sylvia Lui, Lijing Lin, Alex G. Mathioudakis, Joanne Mitchell, Clare Moizer, Katrina Moore, Stuart Moss, Syed Murtuza Baker, Rob Oliver, Grace Padden, Christina Parkinson, Michael Phuycharoen, Ananya Saha, Barbora Salcman, Nicholas A. Scott, Seema Sharma, Jane Shaw, Joanne Shaw, Elizabeth Shepley, Lara Smith, Simon Stephan, Ruth Stephens, G Tavernier, Rhys Tudge, Louis Wareing, Roanna Warren, Thomas Williams, Lisa Willmore, Mehwish Younas,

Long-Term Effects of COVID-19

BackgroundEmerging studies indicate that some coronavirus disease 2019 (COVID-19) patients suffer from persistent symptoms, including breathlessness and chronic fatigue; however, the long-term immune response in these patients presently remains ill-defined.MethodsHere, we describe the phenotypic and functional characteristics of B and T cells in hospitalized COVID-19 patients during acute disease and at 3–6 months of convalescence.FindingsWe report that the alterations in B cell subsets observed in acute COVID-19 patients were largely recovered in convalescent patients. In contrast, T cells from convalescent patients displayed continued alterations with persistence of a cytotoxic program evident in CD8+ T cells as well as elevated production of type 1 cytokines and interleukin-17 (IL-17). Interestingly, B cells from patients with acute COVID-19 displayed an IL-6/IL-10 cytokine imbalance in response to Toll-like receptor activation, skewed toward a pro-inflammatory phenotype. Whereas the frequency of IL-6+ B cells was restored in convalescent patients irrespective of clinical outcome, the recovery of IL-10+ B cells was associated with the resolution of lung pathology.ConclusionsOur data detail lymphocyte alterations in previously hospitalized COVID-19 patients up to 6 months following hospital discharge and identify 3 subgroups of convalescent patients based on distinct lymphocyte phenotypes, with 1 subgroup associated with poorer clinical outcome. We propose that alterations in B and T cell function following hospitalization with COVID-19 could affect longer-term immunity and contribute to some persistent symptoms observed in convalescent COVID-19 patients.FundingProvided by UKRI, Lister Institute of Preventative Medicine, the Wellcome Trust, The Kennedy Trust for Rheumatology Research, and 3M Global Giving.