Lymphopenia-induced T cell proliferation is a hallmark of severe COVID-19
Adamo, S.; Chevrier, S.; Cervia, C.; Zurbuchen, Y.; Räber, M. E.; Yang, L.; Sivapatham, S.; Jacobs, A.; Bächli, E.; Rudiger, A.; Stüssi-Helbling, M.; Huber, L. C.; Schaer, D.; Bodenmiller, B.; Boyman, O.; Nilsson, J.
Show abstract
Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has a broad clinical presentation ranging from asymptomatic infection to fatal disease. Different features associated with the immune response to SARS-CoV-2, such as hyperinflammation and reduction of peripheral CD8+ T cell counts are strongly associated with severe disease. Here, we confirm the reduction in peripheral CD8+ T cells both in relative and absolute terms and identify T cell apoptosis and migration into inflamed tissues as possible mechanisms driving peripheral T cell lymphopenia. Furthermore, we find evidence of elevated serum interleukin-7, thus indicating systemic T cell paucity and signs of increased T cell proliferation in patients with severe lymphopenia. Following T cell lymphopenia in our pseudo-longitudinal time course, we observed expansion and recovery of poly-specific antiviral T cells, thus arguing for lymphopenia-induced T cell proliferation. In summary, this study suggests that extensive T cell loss and subsequent T cell proliferation are characteristic of severe COVID-19.
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