Persistent immune abnormalities discriminate post-COVID syndrome from convalescence

Infection. 2024 Jun;52(3):1087-1097. doi: 10.1007/s15010-023-02164-y. Epub 2024 Feb 7.

Abstract

Background: Innate lymphoid cells (ILCs) are key organizers of tissue immune responses and regulate tissue development, repair, and pathology. Persistent clinical sequelae beyond 12 weeks following acute COVID-19 disease, named post-COVID syndrome (PCS), are increasingly recognized in convalescent individuals. ILCs have been associated with the severity of COVID-19 symptoms but their role in the development of PCS remains poorly defined.

Methods and results: Here, we used multiparametric immune phenotyping, finding expanded circulating ILC precursors (ILCPs) and concurrent decreased group 2 innate lymphoid cells (ILC2s) in PCS patients compared to well-matched convalescent control groups at > 3 months after infection or healthy controls. Patients with PCS showed elevated expression of chemokines and cytokines associated with trafficking of immune cells (CCL19/MIP-3b, FLT3-ligand), endothelial inflammation and repair (CXCL1, EGF, RANTES, IL-1RA, PDGF-AA).

Conclusion: These results define immunological parameters associated with PCS and might help find biomarkers and disease-relevant therapeutic strategies.

Keywords: COVID-19; Immune activation; Innate lymphoid cells; Post-COVID-19-syndrome; Tissue immunology.

MeSH terms

  • Adult
  • Aged
  • COVID-19* / diagnosis
  • COVID-19* / immunology
  • Chemokines / immunology
  • Convalescence*
  • Cytokines* / immunology
  • Female
  • Humans
  • Immunity, Innate
  • Lymphocytes* / immunology
  • Male
  • Middle Aged
  • Post-Acute COVID-19 Syndrome*
  • SARS-CoV-2 / immunology

Substances

  • Cytokines
  • Chemokines