Immunological fingerprint in coronavirus disease-19 convalescents with and without post-COVID syndrome
Max Augustin, Ferdinand Heyn, Stella Ullrich, Ute Sandaradura de Silva, Marie‐Christine Albert, Viktoria Linne, Maike Schlotz, Philipp Schommers, Elisabeth Pracht, Carola Horn, Isabelle Suárez, Alexander Simonis, Lea K. Picard, Alexander Zoufaly, Christoph Wenisch, Gerd Fätkenheuer, Henning Gruell, Florian Klein, Michael Hallek, Henning Walczak, Jan Rybniker, Sebastian J. Theobald, Clara Lehmann
Abstract
Background Symptoms lasting longer than 12 weeks after severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection are called post-coronavirus disease (COVID) syndrome (PCS). The identification of new biomarkers that predict the occurrence or course of PCS in terms of a post-viral syndrome is vital. T-cell dysfunction, cytokine imbalance, and impaired autoimmunity have been reported in PCS. Nevertheless, there is still a lack of conclusive information on the underlying mechanisms due to, among other things, a lack of controlled study designs. Methods Here, we conducted a prospective, controlled study to characterize the humoral and cellular immune response in unvaccinated patients with and without PCS following SARS-CoV-2 infection over 7 months and unexposed donors. Results Patients with PCS showed as early as 6 weeks and 7 months after symptom onset significantly increased frequencies of SARS-CoV-2-specific CD4 + and CD8 + T-cells secreting IFNγ, TNF, and expressing CD40L, as well as plasmacytoid dendritic cells (pDC) with an activated phenotype. Remarkably, the immunosuppressive counterparts type 1 regulatory T-cells (TR1: CD49b/LAG-3 + ) and IL-4 were more abundant in PCS + . Conclusion This work describes immunological alterations between inflammation and immunosuppression in COVID-19 convalescents with and without PCS, which may provide potential directions for future epidemiological investigations and targeted treatments.