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?:abstract
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Profound T-cell lymphopenia is the hallmark of severe Covid-19. T-cell proliferation is telomere length (TL)-dependent and telomeres shorten with age. Older Covid-19 patients, we hypothesize, are therefore at a higher risk of having TL-dependent lymphopenia. We measured TL by the novel Telomere Shortest Length Assay (TeSLA), and by Southern blotting of the terminal restriction fragments (SB) in peripheral blood mononuclear cells of 17 Covid-19 and 21 non-Covid-19 patients, aged 87 ± 8 (mean ± SD) and 87 ± 9 years, respectively. TeSLA tallies and measures single telomeres, including short telomeres undetected by SB. Such telomeres are relevant to TL-mediated biological processes, including cell viability and senescence. TeSLA yields two key metrics: the proportion of telomeres with different lengths (expressed in %), and their mean, TeSLA mTL (expressed in kb). Lymphocyte count (10 9/L) was 0.91 ± 0.42 in Covid-19 patients and 1.50 ± 0.50 in non-Covid-19 patients (P < 0.001). In Covid-19 patients, but not in non-Covid-19 patients, lymphocyte count was inversely correlated with the proportion of telomeres shorter than 2 kb (P = 0.005) and positively correlated with TeSLA mTL (P = 0.03). Lymphocyte count was not significantly correlated with SB mTL in either Covid-19 or non-Covid-19 patients. We propose that compromised TL-dependent T-cell proliferative response, driven by short telomere in the TL distribution, contributes to Covid-19 lymphopenia among old adults. We infer that infection with SARS-CoV-2 uncovers the limits of the TL reserves of older persons.
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