Despite the growing number of patients with persistent symptoms after acute SARS-CoV-2 infection, the pathophysiology underlying long-COVID is not yet well characterized, and there is no established therapy. We performed a deep immune profiling in nine patients with persistent symptoms (PSP), before and after a 4-day prednisone course, and five post-COVID-19 patients without persistent symptoms (NSP). PSP showed a perturbed distribution of circulating mononuclear cell populations. Symptoms in PSP were accompanied by a pro-inflammatory phenotype characterized by increased conventional dendritic cells and augmented expression of antigen presentation, co-stimulation, migration, and activation markers in monocytes. The adaptive immunity compartment in PSP showed a Th1-predominance, decreased naïve and regulatory T cells, and augmentation of the PD-1 exhaustion marker. These immune alterations reverted after the corticosteroid treatment and were maintained during the 4-month follow-up, and their normalization correlated with clinical amelioration. The current work highlights an immunopathogenic basis together with a possible role for steroids in the treatment for long-COVID.
【저자키워드】 Corticosteroids, long-COVID, immunological alterations, 【초록키워드】 Treatment, Monocytes, adaptive, Immunity, Symptom, immune, Migration, pathophysiology, immune profiling, Patient, phenotype, Prednisone, Follow-up, Antigen presentation, distribution, expression, regulatory T cells, dendritic cell, marker, steroid, mononuclear cell, Activation, alteration, naïve, acute SARS-CoV-2 infection, circulating, corticosteroid treatment, pro-inflammatory, populations, FIVE, highlight, established therapy, Course, performed, nine, characterized, correlated, accompanied, post-COVID-19 patient, PSP, 【제목키워드】 alteration,