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?:abstract
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Little is known about the time-dependent immune responses in severe COVID-19. Data of 15 consecutive patients were sequentially recorded from intensive care unit admission. Lymphocyte subsets and total monocyte and subsets counts were monitored as well as the expression of HLA-DR. For 5 patients, SARS-CoV-2–specific T-cell polyfunctionality was assessed against Spike and Nucleoprotein SARS-CoV-2 peptides. Non-specific inflammation markers were increased in all patients. Median monocyte HLA-DR expression was below the 8,000 AB/C threshold defining acquired immunodepression. A “V” trend curve for lymphopenia, monocyte numbers, and HLA-DR expression was observed with a nadir between days 11 and 14 after symptoms’ onset. Intermediate CD14(++)CD16(+) monocytes increased early with a reduction in classic CD14(++)CD16(-) monocytes. Polyfunctional SARS-Cov-2–specific CD4 T-cells were present and functional, whereas virus-specific CD8 T-cells were less frequent and not efficient. We report a temporal variation of both innate and adaptive immunity in severe COVID-19 patients, helpful in guiding therapeutic decisions (e.g. anti-inflammatory vs. immunostimulatory ones). We describe a defect in virus-specific CD8 T-cells, a potential biomarker of clinical severity. These combined data also provide helpful knowledge for vaccine design. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/, identifier NCT04386395
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?:doi
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?:doi
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10.3389/fimmu.2020.580250
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document_parses/pdf_json/dad07b7d7d35368b3bf2a47ae08ae96890b9e60b.json
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document_parses/pmc_json/PMC7597438.xml.json
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?:title
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A Longitudinal Study of Immune Cells in Severe COVID-19 Patients
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