Enhanced inflammation and suppressed adaptive immunity in COVID-19 with prolonged RNA shedding

• Published in: Cell discovery Vol. 8; no. 1; p. 70
• Main Authors: Tang, Xiaohua, Sun, Rui, Ge, Weigang, Mao, Tingting, Qian, Liujia, Huang, Chongquan, Kang, Zhouyang, Xiao, Qi, Luo, Meng, Zhang, Qiushi, Li, Sainan, Chen, Hao, Liu, Wei, Wang, Bingjie, Li, Shufei, Lin, Xiaoling, Xu, Xueqin, Li, Huanzheng, Wu, Lianpeng, Dai, Jianyi, Gao, Huanhuan, Li, Lu, Lu, Tian, Liang, Xiao, Cai, Xue, Ruan, Guan, Xu, Fei, Li, Yan, Zhu, Yi, Kong, Ziqing, Huang, Jianping, Guo, Tiannan
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 25.07.2022; Springer Nature B.V; Nature Publishing Group
• Subjects: 631/250/262; 631/337/475; Adaptive immunity; Biomedical and Life Sciences; Cell Biology; Cell Culture; Cell Cycle Analysis; Cell migration; Cell Physiology; Complement activation; Coronaviruses; COVID-19; Cytokines; Disease transmission; Hospitals; Immunoglobulin G; Inflammation; Life Sciences; Liver X receptors; Lymphocytes T; Metabolites; Metabolomics; Patients; Proteins; Proteomics; Retinoid X receptors; Ribonucleic acid; RNA; Severe acute respiratory syndrome coronavirus 2; Stem Cells; Viral infections
• ISSN: 2056-5968; 2056-5968
• DOI: 10.1038/s41421-022-00441-y

Little is known regarding why a subset of COVID-19 patients exhibited prolonged positivity of SARS-CoV-2 infection. Here, we found that patients with long viral RNA course (LC) exhibited prolonged high-level IgG antibodies and higher regulatory T (Treg) cell counts compared to those with short viral RNA course (SC) in terms of viral load. Longitudinal proteomics and metabolomics analyses of the patient sera uncovered that prolonged viral RNA shedding was associated with inhibition of the liver X receptor/retinoid X receptor (LXR/RXR) pathway, substantial suppression of diverse metabolites, activation of the complement system, suppressed cell migration, and enhanced viral replication. Furthermore, a ten-molecule learning model was established which could potentially predict viral RNA shedding period. In summary, this study uncovered enhanced inflammation and suppressed adaptive immunity in COVID-19 patients with prolonged viral RNA shedding, and proposed a multi-omic classifier for viral RNA shedding prediction.