Immunologic perturbations in severe COVID-19/SARS-CoV-2 infection

Kuri-Cervantes, L.; Pampena, M. B.; Meng, W.; Rosenfeld, A. M.; Ittner, C. A. G.; Weisman, A. R.; Agyekum, R.; Mathew, D.; Baxter, A. E.; Vella, L.; Kuthuru, O.; Apostolidis, S.; Bershaw, L.; Dougherty, J.; Greenplate, A. R.; Pattekar, A.; Kim, J.; Han, N.; Gouma, S.; Weirick, M. E.; Arevalo, C. P.; Bolton, M. J.; Goodwin, E. C.; Anderson, E. M.; Hensley, S. E.; Jones, T. K.; Mangalmurti, N. S.; Luning Prak, E. T.; Meyer, N. J.; Betts, M. R.

doi:10.1101/2020.05.18.101717

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bioRxiv · 10.1101/2020.05.18.101717

Immunologic perturbations in severe COVID-19/SARS-CoV-2 infection

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Abstract

Although critical illness has been associated with SARS-CoV-2-induced hyperinflammation, the immune correlates of severe COVID-19 remain unclear. Here, we comprehensively analyzed peripheral blood immune perturbations in 42 SARS-CoV-2 infected and recovered individuals. We identified broad changes in neutrophils, NK cells, and monocytes during severe COVID-19, suggesting excessive mobilization of innate lineages. We found marked activation within T and B cells, highly oligoclonal B cell populations, profound plasmablast expansion, and SARS-CoV-2-specific antibodies in many, but not all, severe COVID-19 cases. Despite this heterogeneity, we found selective clustering of severe COVID-19 cases through unbiased analysis of the aggregated immunological phenotypes. Our findings demonstrate broad immune perturbations spanning both innate and adaptive leukocytes that distinguish dysregulated host responses in severe SARS-CoV-2 infection and warrant therapeutic investigation. One Sentence SummaryBroad immune perturbations in severe COVID-19

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Kuri-Cervantes, L., Pampena, M. B., Meng, W., Rosenfeld, A. M., Ittner, C. A. G., Weisman, A. R., Agyekum, R., Mathew, D., Baxter, A. E., Vella, L., Kuthuru, O., Apostolidis, S., Bershaw, L., Dougherty, J., Greenplate, A. R., Pattekar, A., Kim, J., Han, N., Gouma, S., Weirick, M. E., Arevalo, C. P., Bolton, M. J., Goodwin, E. C., Anderson, E. M., Hensley, S. E., Jones, T. K., Mangalmurti, N. S., Luning Prak, E. T., Meyer, N. J., Betts, M. R.. 2020-05-18. Immunologic perturbations in severe COVID-19/SARS-CoV-2 infection. https://doi.org/10.1101/2020.05.18.101717

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