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?:abstract
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BACKGROUND SARS-CoV-2 has triggered a pandemic that is now claiming many lives. Several studies have investigated cellular immune responses in COVID-19 patients during disease but little is known regarding a possible protracted impact of COVID-19 on the adaptive and innate immune system in COVID-19-convalescent patients. METHODS We used multiparametric flow cytometry to analyze whole peripheral blood samples, and determined SARS-CoV-2 specific antibody levels against the S-protein, its RBD-subunit and viral nucleocapsid in a cohort of COVID-19 convalescent patients who had mild disease approximately 10 weeks after infection (n=109) and healthy control subjects (n=98). Furthermore, we correlated immunological changes with clinical and demographic parameters. RESULTS Even ten weeks after disease COVID-19 convalescent patients had fewer neutrophils, while their cytotoxic CD8+ T cells were activated, reflected as higher HLA-DR and CD38 expression. Multiparametric regression analyses showed that in COVID-19 patients both CD3+ CD4+ and CD3+ CD8+ effector memory cells were higher, while CD25+ Foxp3+ T regulatory cells were lower. In addition, both transitional B cell and plasmablast levels were significantly elevated in COVID-19 patients. Fever (duration, level) correlated with numbers of central memory CD4+ T cells and anti-S and anti-RBD, but not anti-NC antibody levels. Moreover, a \'young immunological age\' as determined by numbers of CD3+ CD45RA+ CD62L+ CD31+ recent thymic emigrants was associated with a loss of sense of taste and/or smell. CONCLUSION Acute SARS-CoV-2 infection leaves protracted beneficial (i.e., activation of T cells) and potentially harmful (i.e., reduction of neutrophils) imprints in the cellular immune system in addition to induction of specific antibody responses.
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