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Front Immunol . The longitudinal characterization of immune responses in COVID-19 patients reveals novel prognostic signatures for disease severity,

tetano

Editor, Senior Moderator
Front Immunol


. 2024 Jul 29:15:1381091.
doi: 10.3389/fimmu.2024.1381091. eCollection 2024. The longitudinal characterization of immune responses in COVID-19 patients reveals novel prognostic signatures for disease severity, patients' survival and long COVID

Maddalena Noviello[SUP] #[/SUP][SUP] 1 2 [/SUP], Rebecca De Lorenzo[SUP] #[/SUP][SUP] 3 4 [/SUP], Raniero Chimienti[SUP] 5 [/SUP], Norma Maugeri[SUP] 6 [/SUP], Claudia De Lalla[SUP] 7 [/SUP], Gabriel Siracusano[SUP] 8 [/SUP], Nicola Ivan Lorè[SUP] 9 [/SUP], Paola Maria Vittoria Rancoita[SUP] 10 [/SUP], Federica Cugnata[SUP] 10 [/SUP], Elena Tassi[SUP] 1 2 [/SUP], Stefania Dispinseri[SUP] 5 [/SUP], Danilo Abbati[SUP] 1 [/SUP], Valeria Beretta[SUP] 1 2 [/SUP], Eliana Ruggiero[SUP] 1 [/SUP], Francesco Manfredi[SUP] 1 [/SUP], Aurora Merolla[SUP] 3 4 [/SUP], Elisa Cantarelli[SUP] 11 [/SUP], Cristina Tresoldi[SUP] 11 [/SUP], Claudia Pastori[SUP] 8 [/SUP], Roberta Caccia[SUP] 12 [/SUP], Francesca Sironi[SUP] 5 [/SUP], Ilaria Marzinotto[SUP] 13 [/SUP], Fabio Saliu[SUP] 9 [/SUP], Silvia Ghezzi[SUP] 14 [/SUP], Vito Lampasona[SUP] 13 [/SUP], Elisa Vicenzi[SUP] 14 [/SUP], Paola Cinque[SUP] 12 [/SUP], Angelo Andrea Manfredi[SUP] 6 [/SUP], Gabriella Scarlatti[SUP] 5 [/SUP], Paolo Dellabona[SUP] 7 [/SUP], Lucia Lopalco[SUP] 8 [/SUP], Clelia Di Serio[SUP] 10 [/SUP], Mauro Malnati[SUP] 5 [/SUP], Fabio Ciceri[SUP] #[/SUP][SUP] 3 15 [/SUP], Patrizia Rovere-Querini[SUP] #[/SUP][SUP] 3 4 [/SUP], Chiara Bonini[SUP] #[/SUP][SUP] 1 2 3 [/SUP]



Affiliations
Abstract

Introduction: SARS-CoV-2 pandemic still poses a significant burden on global health and economy, especially for symptoms persisting beyond the acute disease. COVID-19 manifests with various degrees of severity and the identification of early biomarkers capable of stratifying patient based on risk of progression could allow tailored treatments.
Methods: We longitudinally analyzed 67 patients, classified according to a WHO ordinal scale as having Mild, Moderate, or Severe COVID-19. Peripheral blood samples were prospectively collected at hospital admission and during a 6-month follow-up after discharge. Several subsets and markers of the innate and adaptive immunity were monitored as putative factors associated with COVID-19 symptoms.
Results: More than 50 immunological parameters were associated with disease severity. A decision tree including the main clinical, laboratory, and biological variables at admission identified low NK-cell precursors and CD14[SUP]+[/SUP]CD91[SUP]+[/SUP] monocytes, and high CD8[SUP]+[/SUP] Effector Memory T cell frequencies as the most robust immunological correlates of COVID-19 severity and reduced survival. Moreover, low regulatory B-cell frequency at one month was associated with the susceptibility to develop long COVID at six months, likely due to their immunomodulatory ability.
Discussion: These results highlight the profound perturbation of the immune response during COVID-19. The evaluation of specific innate and adaptive immune-cell subsets allows to distinguish between different acute and persistent COVID-19 symptoms.

Keywords: COVID-19 patients’ survival; COVID-19 severity; SARS-CoV-2 adaptive immunity; SARS-CoV-2 innate immunity; long COVID.

 
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