Authors: Shuwa, Halima A. et al
Abstract: Background Emerging studies indicate that some COVID-19 patients suffer from persistent symptoms including breathlessness and chronic fatigue; however the long-term immune response in these patients presently remains ill-defined. Methods Here we describe the phenotypic and functional characteristics of B and T cells in hospitalised COVID-19 patients during acute disease and at 3-6 months of convalescence. Findings We report that the alterations in B cell subsets observed in acute COVID-19 patients were largely recovered in convalescent patients. In contrast, T cells from convalescent patients displayed continued alterations with persistence of a cytotoxic programme evident in CD8+ T cells as well as elevated production of type-1 cytokines and IL-17. Interestingly, B cells from patients with acute COVID-19 displayed an IL-6/IL-10 cytokine imbalance in response to toll-like receptor activation, skewed towards a pro-inflammatory phenotype. Whereas the frequency of IL-6+ B cells was restored in convalescent patients irrespective of clinical outcome, recovery of IL-10+ B cells was associated with resolution of lung pathology. Conclusions Our data detail lymphocyte alterations in previously hospitalized COVID-19 patients up to 6 months following hospital discharge and identify 3 subgroups of convalescent patients based on distinct lymphocyte phenotypes, with one subgroup associated with poorer clinical outcome. We propose that alterations in B and T cell function following hospitalisation with COVID-19 could impact longer term immunity and contribute to some persistent symptoms observed in convalescent COVID-19 patients. Funding Provided by UKRI, Lister Institute of Preventative Medicine, The Wellcome Trust, The Kennedy Trust for Rheumatology Research and 3M Global Giving.
Journal: Med (N Y)
Author-provided data: 
paper: Shuwa, H. A., Shaw, T. N., Knight, S. B., Wemyss, K., McClure, F. A., Pearmain, L., Prise, I., Jagger, C., Morgan, D., Khan, S., Brand, O., Mann, E. R., Ustianowski, A., Bakerly, N. D., Dark, P., Brightling, C. E., Brij, S., Felton, T., Simpson, A., Grainger, J. R., Hussell, T., Konkel, J. E. and Menon, M. (2021). Alterations in T and B cell function persist in convalescent COVID-19 patients. Med (N Y) https://doi.org/10.1016/j.medj.2021.03.013
contributor: Madhvi Menon
contributor_organization: University of Manchester
- description: B and T lymphocyte signatures identify 3 novel subgroups of convalescent COVID-19 patients with distinct clinical outcomes
- exact_source: Figure 4
- tissue: PBMC
- immune_exposure: COVID-19 infection
- cohort: 28-69 years old
- comparison: mild/moderate/severe acute COVID-19 patients (within 7 days of hospitalization) and convalescent COVID-19 patients (at 8-19 weeks post hospital discharge)
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