Persistent Overactive Cytotoxic Immune Response in a Spanish Cohort of Individuals With Long-COVID: Identification of Diagnostic Biomarkers
Front. Immunol., 25 March 2022 | https://doi.org/10.3389/fimmu.2022.848886
Miguel Galán1†, Lorena Vigón1†, Daniel Fuertes2, María Aránzazu Murciano-Antón3, Guiomar Casado-Fernández1, Susana Domínguez-Mateos3, Elena Mateos1,4, Fernando Ramos-Martín1, Vicente Planelles5, Montserrat Torres1, Sara Rodríguez-Mora1,4, María Rosa López-Huertas1,4*‡ and Mayte Coiras1,4*‡ on behalf of Multidisciplinary Group of Study of COVID-19 (MGS-COVID)
1Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
2School of Telecommunications Engineering, Universidad Politécnica de Madrid, Madrid, Spain
3Family Medicine, Centro de Salud Doctor Pedro Laín Entralgo, Madrid, Spain
4Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Madrid, Spain
5Division of Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, UT, United States
Differences at 49 weeks: subset of table in PDF
Long-COVID is a new emerging syndrome worldwide that is characterized by the persistence of unresolved signs and symptoms of COVID-19 more than 4 weeks after the infection and even after more than 12 weeks. The underlying mechanisms for Long-COVID are still undefined, but a sustained inflammatory response caused by the persistence of SARS-CoV-2 in organ and tissue sanctuaries or resemblance with an autoimmune disease are within the most considered hypotheses. In this study, we analyzed the usefulness of several demographic, clinical, and immunological parameters as diagnostic biomarkers of Long-COVID in one cohort of Spanish individuals who presented signs and symptoms of this syndrome after 49 weeks post-infection, in comparison with individuals who recovered completely in the first 12 weeks after the infection. We determined that individuals with Long-COVID showed significantly increased levels of functional memory cells with high antiviral cytotoxic activity such as CD8+ TEMRA cells, CD8±TCR?d+ cells, and NK cells with CD56+CD57+NKG2C+ phenotype. The persistence of these long-lasting cytotoxic populations was supported by enhanced levels of CD4+ Tregs and the expression of the exhaustion marker PD-1 on the surface of CD3+ T lymphocytes.
With the use of these immune parameters and significant clinical features such as lethargy, pleuritic chest pain, and dermatological injuries, as well as demographic factors such as female gender and O+ blood type, a Random Forest algorithm predicted the assignment of the participants in the Long-COVID group with 100% accuracy. The definition of the most accurate diagnostic biomarkers could be helpful to detect the development of Long-COVID and to improve the clinical management of these patients.
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Mild Long-Haul 4.2 X more likely if type O blood (has no A or B antigens)
Mild Long-Haul 4.2 X more likely if type O blood - preprint March 16, 2022