Integrated immune dynamics define correlates of COVID-19 severity and antibody responses.
CELL REPORTS MEDICINE 2021;
2:100208. [PMID:
33564749 PMCID:
PMC7862905 DOI:
10.1016/j.xcrm.2021.100208]
[Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/05/2020] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
Abstract
SARS-CoV-2 causes a spectrum of COVID-19 disease, the immunological basis of which remains ill defined. We analyzed 85 SARS-CoV-2-infected individuals at acute and/or convalescent time points, up to 102 days after symptom onset, quantifying 184 immunological parameters. Acute COVID-19 presented with high levels of IL-6, IL-18, and IL-10 and broad activation marked by the upregulation of CD38 on innate and adaptive lymphocytes and myeloid cells. Importantly, activated CXCR3+cTFH1 cells in acute COVID-19 significantly correlate with and predict antibody levels and their avidity at convalescence as well as acute neutralization activity. Strikingly, intensive care unit (ICU) patients with severe COVID-19 display higher levels of soluble IL-6, IL-6R, and IL-18, and hyperactivation of innate, adaptive, and myeloid compartments than patients with moderate disease. Our analyses provide a comprehensive map of longitudinal immunological responses in COVID-19 patients and integrate key cellular pathways of complex immune networks underpinning severe COVID-19, providing important insights into potential biomarkers and immunotherapies.
Analyses of 184 immune features define kinetics of immune responses to SARS-CoV-2
Circulating TFH1 cells in acute COVID-19 correlate with antibodies
sIL-6R levels are elevated in severe COVID-19 but do not correlate with IL-6
Elevated IL-6 and IL-18 correlate with immune cell hyperactivation
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