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Postmortem high-dimensional immune profiling of severe COVID-19 patients reveals distinct patterns of immunosuppression and immunoactivation #MMPMID35022412
Wu H; He P; Ren Y; Xiao S; Wang W; Liu Z; Li H; Wang Z; Zhang D; Cai J; Zhou X; Jiang D; Fei X; Zhao L; Zhang H; Liu Z; Chen R; Li W; Wang C; Zhang S; Qin J; Nashan B; Sun C
Nat Commun 2022[Jan]; 13 (1): 269 PMID35022412show ga
A complete diagnostic autopsy is the gold-standard to gain insight into Coronavirus disease 2019 (COVID-19) pathogenesis. To delineate the in situ immune responses to SARS-CoV-2 viral infection, here we perform comprehensive high-dimensional transcriptional and spatial immune profiling in 22 COVID-19 decedents from Wuhan, China. We find TIM-3-mediated and PD-1-mediated immunosuppression as a hallmark of severe COVID-19, particularly in men, with PD-1(+) cells being proximal rather than distal to TIM-3(+) cells. Concurrently, lymphocytes are distal, while activated myeloid cells are proximal, to SARS-CoV-2 viral antigens, consistent with prevalent SARS-CoV-2 infection of myeloid cells in multiple organs. Finally, viral load positively correlates with specific immunosuppression and dendritic cell markers. In summary, our data show that SARS-CoV-2 viral infection induces lymphocyte suppression yet myeloid activation in severe COVID-19, so these two cell types likely have distinct functions in severe COVID-19 disease progression, and should be targeted differently for therapy.