Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection

• Published in: Nature immunology Vol. 23; no. 2; pp. 210 - 216
• Main Authors: Phetsouphanh, Chansavath, Darley, David R, Wilson, Daniel B, Howe, Annett, Munier, C Mee Ling, Patel, Sheila K, Juno, Jennifer A, Burrell, Louise M, Kent, Stephen J, Dore, Gregory J, Kelleher, Anthony D, Matthews, Gail V
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01.02.2022
• Subjects: Adult; Aged; B-Lymphocytes - immunology; B-Lymphocytes - metabolism; B-Lymphocytes - virology; Biomarkers - blood; Case-Control Studies; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - complications; COVID-19 - immunology; COVID-19 - virology; Cytokines - blood; Female; Host-Pathogen Interactions; Humans; Immune system; Immunity, Innate; Immunology; Infections; Inflammation; Inflammation Mediators - blood; Interleukin 6; Lymphocytes B; Male; Middle Aged; Patients; Post-Acute COVID-19 Syndrome; Prognosis; SARS-CoV-2 - immunology; SARS-CoV-2 - pathogenicity; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; T-Lymphocytes - immunology; T-Lymphocytes - metabolism; T-Lymphocytes - virology; Time Factors; β-Interferon; γ-Interferon
• ISSN: 1529-2908; 1529-2916
• DOI: 10.1038/s41590-021-01113-x

A proportion of patients surviving acute coronavirus disease 2019 (COVID-19) infection develop post-acute COVID syndrome (long COVID (LC)) lasting longer than 12 weeks. Here, we studied individuals with LC compared to age- and gender-matched recovered individuals without LC, unexposed donors and individuals infected with other coronaviruses. Patients with LC had highly activated innate immune cells, lacked naive T and B cells and showed elevated expression of type I IFN (IFN-β) and type III IFN (IFN-λ1) that remained persistently high at 8 months after infection. Using a log-linear classification model, we defined an optimal set of analytes that had the strongest association with LC among the 28 analytes measured. Combinations of the inflammatory mediators IFN-β, PTX3, IFN-γ, IFN-λ2/3 and IL-6 associated with LC with 78.5-81.6% accuracy. This work defines immunological parameters associated with LC and suggests future opportunities for prevention and treatment.