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Immune responses in COVID-19 respiratory tract and blood reveal mechanisms of disease severity.


ABSTRACT: Although the respiratory tract is the primary site of SARS-CoV-2 infection and the ensuing immunopathology, respiratory immune responses are understudied and urgently needed to understand mechanisms underlying COVID-19 disease pathogenesis. We collected paired longitudinal blood and respiratory tract samples (endotracheal aspirate, sputum or pleural fluid) from hospitalized COVID-19 patients and non-COVID-19 controls. Cellular, humoral and cytokine responses were analysed and correlated with clinical data. SARS-CoV-2-specific IgM, IgG and IgA antibodies were detected using ELISA and multiplex assay in both the respiratory tract and blood of COVID-19 patients, although a higher receptor binding domain (RBD)-specific IgM and IgG seroconversion level was found in respiratory specimens. SARS-CoV-2 neutralization activity in respiratory samples was detected only when high levels of RBD-specific antibodies were present. Strikingly, cytokine/chemokine levels and profiles greatly differed between respiratory samples and plasma, indicating that inflammation needs to be assessed in respiratory specimens for the accurate assessment of SARS-CoV-2 immunopathology. Diverse immune cell subsets were detected in respiratory samples, albeit dominated by neutrophils. Importantly, we also showed that dexamethasone and/or remdesivir treatment did not affect humoral responses in blood of COVID-19 patients. Overall, our study unveils stark differences in innate and adaptive immune responses between respiratory samples and blood and provides important insights into effect of drug therapy on immune responses in COVID-19 patients.

SUBMITTER: Zhang W 

PROVIDER: S-EPMC8404907 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Immune responses in COVID-19 respiratory tract and blood reveal mechanisms of disease severity.

Zhang Wuji W   Chua Brendon B   Selva Kevin K   Kedzierski Lukasz L   Ashhurst Thomas T   Haycroft Ebene E   Shoffner Suzanne S   Hensen Luca L   Boyd David D   James Fiona F   Mouhtouris Effie E   Kwong Jason J   Chua Kyra K   Drewett George G   Copaescu Ana A   Dobson Julie J   Rowntree Louise L   Habel Jennifer J   Allen Lilith L   Koay Hui-Fern HF   Neil Jessica J   Gartner Matthew M   Lee Christina C   Andersson Patiyan P   Seemann Torsten T   Sherry Norelle N   Amanat Fatima F   Krammer Florian F   Londrigan Sarah S   Wakim Linda L   King Nicholas N   Godfrey Dale D   Mackay Laura L   Thomas Paul P   Nicholson Suellen S   Arnold Kelly K   Chung Amy A   Holmes Natasha N   Smibert Olivia O   Trubiano Jason J   Gordon Claire C   Nguyen Thi T   Kedzierska Katherine K  

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Although the respiratory tract is the primary site of SARS-CoV-2 infection and the ensuing immunopathology, respiratory immune responses are understudied and urgently needed to understand mechanisms underlying COVID-19 disease pathogenesis. We collected paired longitudinal blood and respiratory tract samples (endotracheal aspirate, sputum or pleural fluid) from hospitalized COVID-19 patients and non-COVID-19 controls. Cellular, humoral and cytokine responses were analysed and correlated with cli  ...[more]

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