High levels of SARS-CoV-2-specific T cells with restricted functionality in severe courses of COVID-19

• Published in: JCI insight Vol. 5; no. 20
• Main Authors: Schub, David, Klemis, Verena, Schneitler, Sophie, Mihm, Janine, Lepper, Philipp M, Wilkens, Heinrike, Bals, Robert, Eichler, Hermann, Gärtner, Barbara C, Becker, Sören L, Sester, Urban, Sester, Martina, Schmidt, Tina
• Format: Journal Article
• Language: English
• Published: United States American Society for Clinical Investigation 15-10-2020; American Society for Clinical investigation
• Subjects: Adult; Antibodies, Viral - blood; Antibodies, Viral - classification; Betacoronavirus - immunology; Betacoronavirus - isolation & purification; Cardiovascular Diseases - epidemiology; Clinical Medicine; Comorbidity; Coronavirus Infections - blood; Coronavirus Infections - epidemiology; Coronavirus Infections - physiopathology; Coronavirus Infections - virology; Correlation of Data; COVID-19; Critical Care - methods; Critical Care - statistics & numerical data; Critical Illness - therapy; Cytokines - blood; Female; Germany - epidemiology; Humans; Leukocyte Count - methods; Leukocyte Count - statistics & numerical data; Lymphocyte Subsets - classification; Male; Metabolic Diseases - epidemiology; Middle Aged; Pandemics; Pneumonia, Viral - blood; Pneumonia, Viral - epidemiology; Pneumonia, Viral - physiopathology; Pneumonia, Viral - virology; SARS-CoV-2; Severity of Illness Index; T-Lymphocytes - classification; T-Lymphocytes - virology; Germany; COVID-19; Immunoglobulins; T cells; Cellular immune response
• ISSN: 2379-3708; 2379-3708
• DOI: 10.1172/jci.insight.142167

BACKGROUNDPatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) differ in the severity of disease. We hypothesized that characteristics of SARS-CoV-2-specific immunity correlate with disease severity.METHODSIn this study, SARS-CoV-2-specific T cells and antibodies were characterized in uninfected controls and patients with different coronavirus disease 2019 (COVID-19) disease severity. SARS-CoV-2-specific T cells were flow cytometrically quantified after stimulation with SARS-CoV-2 peptide pools and analyzed for expression of cytokines (IFN-γ, IL-2, and TNF-α) and markers for activation, proliferation, and functional anergy. SARS-CoV-2-specific IgG and IgA antibodies were quantified using ELISA. Moreover, global characteristics of lymphocyte subpopulations were compared between patient groups and uninfected controls.RESULTSDespite severe lymphopenia affecting all major lymphocyte subpopulations, patients with severe disease mounted significantly higher levels of SARS-CoV-2-specific T cells as compared with convalescent individuals. SARS-CoV-2-specific CD4+ T cells dominated over CD8+ T cells and closely correlated with the number of plasmablasts and SARS-CoV-2-specific IgA and IgG levels. Unlike in convalescent patients, SARS-CoV-2-specific T cells in patients with severe disease showed marked alterations in phenotypical and functional properties, which also extended to CD4+ and CD8+ T cells in general.CONCLUSIONGiven the strong induction of specific immunity to control viral replication in patients with severe disease, the functionally altered characteristics may result from the need for contraction of specific and general immunity to counteract excessive immunopathology in the lung.FUNDINGThe study was supported by institutional funds to MS and in part by grants of Saarland University, the State of Saarland, and the Rolf M. Schwiete Stiftung.