While numerous studies have already compared the immune responses against SARS-CoV-2 in severely and mild-to-moderately ill COVID-19 patients, longitudinal trajectories are still scarce. We therefore set out to analyze serial blood samples from mild-to-moderately ill patients in order to define the immune landscapes for differently progressed disease stages. Twenty-two COVID-19 patients were subjected to consecutive venipuncture within seven days after diagnosis or admittance to hospital. Flow cytometry was performed to analyze peripheral blood immune cell compositions and their activation as were plasma levels of cytokines and SARS-CoV-2 specific immunoglobulins. Healthy donors served as controls. Integrating the kinetics of plasmablasts and SARS-CoV-2 specific antibodies allowed for the definition of three disease stages of early COVID-19. The incubation phase was characterized by a sharp increase in pro-inflammatory monocytes and terminally differentiated cytotoxic T cells. The latter correlated significantly with elevated concentrations of IP-10. Early acute infection featured a peak in PD-1 + cytotoxic T cells, plasmablasts and increasing titers of virus specific antibodies. During late acute infection, immature neutrophils were enriched, whereas all other parameters returned to baseline. Our findings will help to define landmarks that are indispensable for the refinement of new anti-viral and anti-inflammatory therapeutics, and may also inform clinicians to optimize treatment and prevent fatal outcomes.
【저자키워드】 COVID-19, antibodies, SARS-CoV-2, IP-10, Cytotoxic T cells, disease phases, plasmablasts, acute infection, 【초록키워드】 Treatment, Neutrophils, Monocytes, immune response, Cytokines, Anti-inflammatory, T cells, immunoglobulins, hospital, Diagnosis, cytokine, virus, flow cytometry, immune, Anti-viral, PD-1, Peripheral blood, outcomes, Kinetics, Cytotoxic T cells, plasmablasts, acute infection, immune responses, trajectory, plasma, COVID-19 patients, Donor, specific antibodies, Concentration, Immune cell, Plasma levels, COVID-19 patient, Cytometry, Flow, SARS-CoV-2 specific antibody, Definition, Activation, clinician, healthy donors, SARS-CoV-2 specific antibodies, disease stage, blood sample, help, plasmablast, disease stages, admittance, pro-inflammatory monocytes, refinement, while, parameter, venipuncture, Prevent, controls, Seven, significantly, elevated, was performed, characterized, correlated, increase in, to define, returned, baseline, ill patient, immature neutrophil, pro-inflammatory monocyte, progressed, terminally differentiated, 【제목키워드】 Incubation, acute disease, Stage, distinguishing,