Abstract
SummaryBackgroundEmerging 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.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic, caused by the emergence of a novel coronavirus strain, has resulted at this time in >106 million infections and 2.3 million deaths worldwide
The compilation of lymphocyte parameters in convalescent COVID-19 patients identified 3 distinct patient subgroups, with 1 subgroup associated with poorer clinical outcome
Clinical characteristics Between March 29 and July 15, 2020, we recruited patients during their in-patient stay for COVID-19, who had clinical and lymphocyte data available and who were recruited within 7 days of admission. ‘‘Convalescent’’ patients were recruited between July 14 and October 2020 from outpatient clinical follow-up for COVID-19
Summary
The coronavirus disease 2019 (COVID-19) pandemic, caused by the emergence of a novel coronavirus strain, has resulted at this time in >106 million infections and 2.3 million deaths worldwide. Infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has a plethora of consequences, ranging from mild influenzalike symptoms to life-threatening and fatal acute respiratory distress syndrome.[1,2] In all cases, the pathology is underpinned by not merely the virus itself and an Context and significance The coronavirus disease 2019 (COVID-19) pandemic, caused by a novel coronavirus strain, has resulted in >100 million infections worldwide. The compilation of lymphocyte parameters in convalescent COVID-19 patients identified 3 distinct patient subgroups, with 1 subgroup associated with poorer clinical outcome. Our study outlines lymphocyte changes in convalescent COVID-19 patients associated with negative effects on subsequent health
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