Post-acute COVID-19 associated with evidence of bystander T-cell activation and a recurring antibiotic-resistant bacterial pneumonia
Michaela Gregorová, Daniel Morse, Tarcisio Brignoli, Joseph Steventon, Fergus Hamilton, Mahableshwar Albur, David Arnold, Matthew C. Thomas, Alice Halliday, Holly E. Baum, Christopher M. Rice, Matthew B. Avison, Andrew D. Davidson, Marianna Santopaolo, Elizabeth Oliver, Anu Goenka, Adam Finn, Linda Wooldridge, Borko Amulic, Rosemary J. Boyton, Daniel M. Altmann, David K. Butler, Claire McMurray, Joanna Stockton, Samuel M. Nicholls, Charles Cooper, Nicholas J. Loman, Michael J. Cox, Laura Rivino, Ruth C. Massey
Abstract
Here, we describe the case of a COVID-19 patient who developed recurring ventilator-associated pneumonia caused by Pseudomonas aeruginosa that acquired increasing levels of antimicrobial resistance (AMR) in response to treatment. Metagenomic analysis revealed the AMR genotype, while immunological analysis revealed massive and escalating levels of T-cell activation. These were both SARS-CoV-2 and P. aeruginosa specific, and bystander activated, which may have contributed to this patient’s persistent symptoms and radiological changes.