Short and long-term immune changes in different severity groups of COVID-19 disease

• Published in: International journal of infectious diseases Vol. 122; pp. 776 - 784
• Main Authors: Maamari, Khuloud Al, Busaidi, Ibrahim Al, Kindi, Mahmood Al, Zadjali, Fahad, BaAlawi, Fatma, Anesta, Wijesinghe, Amri, Kawthar Al, Albalushi, Wafa, Balushi, Hamed Al, Amri, Ayman Al, Aljufaili, Mahmood, Al-Busaidi, Mujahid, Muharrmi, Zakariya Al, Balkhair, Abdullah, Riyami, Nafila Al, Ghanim, Zahraa, Alshekaili, Jalila
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01-09-2022; The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: Adaptive immunity; Adult; CD8-Positive T-Lymphocytes; Cellular immune response; COVID-19; Humans; Immunology; Prospective Studies; SARS-CoV-2; T cells; T-Lymphocyte Subsets; COVID-19; Adaptive immunity; Immunology; T cells; Cellular immune response
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2022.07.026

•Moderate and severe/critical groups had high inflammation at presentation.•Inflammation did not normalize for the severe/critical at 2 weeks.•Mild and moderate groups had good T and B memory responses at 2 weeks.•Severe/critical group had an exhausted immune response at 2 weeks.•By 24 weeks, severe/critical group had good memory B and T cell responses.
There are limited data on short- versus long-term changes in adaptive immune response across different COVID-19 disease severity groups.
A multicenter prospective study of 140 adult patients with COVID-19 (a total of 325 samples) were analyzed for inflammatory markers and lymphocyte subsets at presentation, week 2, and week 24.
Inflammatory markers at presentation were higher in the critical/severe than in moderate and mild groups. A predominance of memory B cell response in the mild and moderate group was noted by week 2. In contrast, the immune system in the severe/critical group was dysfunctional, with expansion of exhausted CD8+ T cells and atypical memory B cells. By 24 weeks, there was a possible trend of normalization.
There was substantial difference in the degree of inflammation and distribution of different B and T cell subsets in the different disease severity groups. Despite the initial dysfunctional immune response in the severe/critical group, a comparable memory B and CD8+ T cell responses to the mild group was achieved at 24 weeks.