biostudies-literaturePickering HBLRD VANCATS NIH HHSNIAID NIH HHSNHLBI NIH HHSU.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood InstituteU.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI)586https://www.ebi.ac.uk/biostudies/studies/S-EPMC11723965biostudies-literatureUnknown16(1)Coronavirus disease 2019 (COVID-19) poses significant risks for solid organ transplant recipients, who have atypical but poorly characterized immune responses to infection. We aim to understand the host immunologic and microbial features of COVID-19 in transplant recipients by leveraging a prospective multicenter cohort of 86 transplant recipients age- and sex-matched with 172 non-transplant controls. We find that transplant recipients have higher nasal SARS-CoV-2 viral abundance and impaired viral clearance, and lower anti-spike IgG levels. In addition, transplant recipients exhibit decreased plasmablasts and transitional B cells, and increased senescent T cells. Blood and nasal transcriptional profiling demonstrate unexpected upregulation of innate immune signaling pathways and increasedNature communicationsHost-microbe multiomic profiling identifies distinct COVID-19 immune dysregulation in solid organ transplant recipients.PMC11723965R01 AI135803R01 AI104870U19 AI090023U19 AI062629UL1 TR001863U54 AI142766U19 AI118610R01 HL155418U19 AI077439P01 AI153559I01 BX005023R01 AI145835U19 AI118608U19 AI125357U19 AI057229U19 AI1289105R01HL155418U19 AI128913U19 AI089992Cauley JBristow LGoonewardene IMRivera AMLlamas MMulder LCFBechnak AAbraham JHayati ANVita RPierce LSmith CMFatou BKutzler MACarrillo SSong LZLeroux CPatel RBoddapati AKDandekar RKo AILeipold MManohar MDavis MMBell MRSalehi-Rad RPresnell SPatel MDin HNXu LKaroly MKim-Schulze SBaden LRMaguire CGhale RHough CLSmolen KKMonahan BDo EWylie DYang SSConnors JMatthay MMMontgomery RRLin EWoloszczuk KBime CPhan HVFurukawa SLevy OGonzalez ALea TMartens MArnett AQi JBermudez-Gonzalez MCEckalbar WHamilton SSchroeder AWZhao YHutton SRFragiadakis GKHellmeister KSieg SGabernet GMicheletti CKleinstein SHKelly GWong KRogers JEJenkins MAsthana SMege NSigal NShannon CPRamires-Sanchez EGeltman JNJoyner DSchearer PPellegrini KLJha MMuenker MCHendrickson CMTietje-Ulrich GWestendorf KAtkinson MAKohr BAltman DCotsapas CTcheou JSalahuddin SChaudhary OPeters BKonstorum ASherman ACSigman ASchunk RMilliren CEPaz MTRao AHagan TViode AAzad ARothman JCarter EBrakenridge SMaecker HTUsher JSekaly RPReed EFCowan DNelson AArtandi MSutter NRousseau JFCoulter FJFarrugia KDela Cruz CChang JBPEvans BTegos GPOzonoff AChen JMelamed ESamaha HCooney MNelson EWimalasena SAlvarenga BBrakenridge SCTribout HWoodruff PGAbe KChen EKrauss JJones NNadeau KCLi XTharp GKStrand MBrito AFernandes ALeligdowicz AMolzahn ASemenza NCUlring KWard DCShaheen Tvan Zalm PRosenberg-Hasson YRaskin ASteen HSullivan LElashoff DBarton BLiu SMorris SMaecker HKrammer FAnderson EJCiric CRSaksena MLasky-Su JMurphy MDAsashima HDesjardins MSiegel SARJohnson BRajan JBrunton AEMelnyk NHolland SMDutta JAltman MCPanganiban BErickson HHussaini LBeagle ESiles NGuan LHarris PMcLin RHewitt LWunder EBeagle ASanthosh LMitre XBielak DAlbert MBosinger SERashid SMoldawer LFried MTsitsiklis AMendez KSeyfert-Margolis VMohanty SFrancisco DSheidy JFung MHiguita NIAConway MLangelier CRHughes TSevransky JEWilson MStadlbauer DVasquez JJvan Haren Svan de Guchte ASchaenman JAugustine ADMick EAltamirano LTTong ARogowski BPickering HMcComsey GAWalsh SRMetcalf JPMilush JSullivan PEEhrlich LIRMontesano CSimmons BMichelotti GBrown BRKrummel MFConsolo MKhalil ZYoung HPKimura HCoppi ALove CSinger JRooks RCusimano GAhuja NPerdomo CLee SThakur NGygi JPShaw AMagyar CEFournier JShaw CYellin TChinthrajah SLee DEaker LQYendewa GAgudelo Higuita NILee ECalfee CSTang KLee BEsserman DBeach KFBlish CEdwards CRuff WThomas SErle DJLentucci CShaw ACShulz WLChang ICroen BJauregui AFourati SCheng AKho ATBaden LBryant RSominsky LAJancsyk TRaddassi KRainone MKangelaris KNGuerrero YSLyski ZLMaliskova LFarhadian SCuriel CHodder TKleiner GMehta AIzaguirre NGeng LNAdkisson MBhide SFulcher JLota RMcnair NDuchen DVaysman TLu ZHuerta CSimon VPrasad PWang HLee ASWang KSaluvan MKheradmand FSingh GBernui MRouphael NGrubaugh NDScherer EMXie HPawar SCorry DBWang XDoni Jayavelu NSamad BPowell DLOberhaus JUngaro RFGonzalez-Reiche ASKim JNRahman AWilson CCDiray-Arce JBorresen BHaddad EKRosen LBCairns CBPulendran BSyphurs CSen SSinha PStevenson DGuirgis FWBrook JKraft MSpainhour CMcEnaney KWard AHurley KCIMPACC NetworkKojic ESinko LARodriguez NKhan ZHoch AHafler DAOverton JABetancourt LWillmore ABooth JLIwasaki AAnderson MLTipan PGChang ACIssa NCChak SNagle CManning BRTebbutt SJMesser WBNguyen VRogers ARashid ASJayavelu NDNie KMesser WMosier JPetrova BSierra BVijayakumar PKanarek NCarreno JMKawabata HRibeiro SPVan Bakel HSrivastava KHolmes THFernandez-Sesma ARoque JDrevets DABecker PMLicona JHAbe-Jones YfalseHost-microbe multiomic profiling identifies distinct COVID-19 immune dysregulation in solid organ transplant recipients.Coronavirus disease 2019 (COVID-19) poses significant risks for solid organ transplant recipients, who have atypical but poorly characterized immune responses to infection. We aim to understand the host immunologic and microbial features of COVID-19 in transplant recipients by leveraging a prospective multicenter cohort of 86 transplant recipients age- and sex-matched with 172 non-transplant controls. We find that transplant recipients have higher nasal SARS-CoV-2 viral abundance and impaired viral clearance, and lower anti-spike IgG levels. In addition, transplant recipients exhibit decreased plasmablasts and transitional B cells, and increased senescent T cells. Blood and nasal transcriptional profiling demonstrate unexpected upregulation of innate immune signaling pathways and increased2025-01-01T00:00:00Z2025 Jan2026-06-01T05:06:26.889Z2026-04-08T09:26:09.781ZS-EPMC117239653979431910.1038/s41467-025-55823-z