Burnett Cassandra E, Okholm Trine Line Hauge, Tenvooren Iliana, Marquez Diana M, Tamaki Stanley, Sandoval Priscila Munoz, Calfee Carolyn S, Hendrickson Carolyn M, Kangelaris Kirsten N, Langelier Charles R, Krummel Matthew F, Woodruff Prescott G, Erle David J, Ansel K Mark, Spitzer Matthew H
Departments of Otolaryngology-Head and Neck Cancer, University of California, San Francisco, San Francisco, CA 94143, USA.
Department of Immunology & Immunology and Sandler Asthma Basic Research Center, University of California, San Francisco, San Francisco, CA 94143, USA.
bioRxiv. 2022 Mar 16:2022.03.15.484467. doi: 10.1101/2022.03.15.484467.
Many studies have provided insights into the immune response to COVID-19; however, little is known about the immunological changes and immune signaling occurring during COVID-19 resolution. Individual heterogeneity and variable disease resolution timelines obscure unifying immune characteristics. Here, we collected and profiled >200 longitudinal peripheral blood samples from patients hospitalized with COVID-19, with other respiratory infections, and healthy individuals, using mass cytometry to measure immune cells and signaling states at single cell resolution. COVID-19 patients showed a unique immune composition and an early, coordinated and elevated immune cell signaling profile, which correlated with early hospital discharge. Intra-patient time course analysis tied to clinically relevant events of recovery revealed a conserved set of immunological processes that accompany, and are unique to, disease resolution and discharge. This immunological process, together with additional changes in CD4 regulatory T cells and basophils, accompanies recovery from respiratory failure and is associated with better clinical outcomes at the time of admission. Our work elucidates the biological timeline of immune recovery from COVID-19 and provides insights into the fundamental processes of COVID-19 resolution in hospitalized patients.
