Although critical illness has been associated with SARS-CoV-2-induced hyperinflammation, the immune correlates of severe COVID-19 remain unclear. Here, we comprehensively analyzed peripheral blood immune perturbations in 42 SARS-CoV-2 infected and recovered individuals. We identified extensive induction and activation of multiple immune lineages, including T cell activation, oligoclonal plasmablast expansion, and Fc and trafficking receptor modulation on innate lymphocytes and granulocytes, that distinguished severe COVID-19 cases from healthy donors or SARS-CoV-2-recovered or moderate severity patients. We found the neutrophil to lymphocyte ratio to be a prognostic biomarker of disease severity and organ failure. Our findings demonstrate broad innate and adaptive leukocyte perturbations that distinguish dysregulated host responses in severe SARS-CoV-2 infection and warrant therapeutic investigation. Profound plasmablast expansion, innate cell modulation, and T cell activation are defining features of severe COVID-19.
【초록키워드】 SARS-CoV-2, adaptive, severe COVID-19, severity, disease severity, neutrophil, Infection, host response, immune, Peripheral blood, lymphocyte, hyperinflammation, therapeutic, receptor, lineages, Critical, moderate, patients, prognostic biomarker, T cell activation, Perturbation, Organ failure, leukocyte, Activation, modulation, feature, severe SARS-CoV-2, healthy donor, analyzed, individuals, dysregulated, immune correlate, innate cell, 【제목키워드】 severe COVID-19, immune, Perturbation, Comprehensive,