Summary Severe disease of SARS-CoV-2 is characterized by vigorous inflammatory responses in the lung, often with a sudden onset after 5–7 days of stable disease. Efforts to modulate this hyperinflammation and the associated acute respiratory distress syndrome rely on the unraveling of the immune cell interactions and cytokines that drive such responses. Given that every patient is captured at different stages of infection, longitudinal monitoring of the immune response is critical and systems-level analyses are required to capture cellular interactions. Here, we report on a systems-level blood immunomonitoring study of 37 adult patients diagnosed with COVID-19 and followed with up to 14 blood samples from acute to recovery phases of the disease. We describe an IFNγ-eosinophil axis activated before lung hyperinflammation and changes in cell-cell co-regulation during different stages of the disease. We also map an immune trajectory during recovery that is shared among patients with severe COVID-19. Graphical Abstract Highlights Immunomonitoring from acute to recovery phase COVID-19 An IFNγ-eosinophil axis precedes lung hyperinflammation Basophils modulate SARS-CoV-2 IgG responses A shared trajectory of immunological recovery in COVID-19 Immune dysregulation plays a pivotal role during severe COVID-19. Rodriguez et al. present a systems-level, longitudinal study of 37 COVID-19 patients monitored from acute to recovery phases of disease. This study reveals cell-protein dependencies and co-regulated features, as well as a shared immunological trajectory during recovery.
【저자키워드】 COVID-19, SARS-CoV-2, systems immunology, mass cytometry, plasma proteins, human immunology, 【초록키워드】 immune response, severe COVID-19, Infection, lung, cytokine, immune, Features, response, hyperinflammation, Patient, trajectory, disease, Critical, SARS-CoV-2 IgG, Blood, acute respiratory distress, basophil, Interaction, Inflammatory response, Analysis, Immune cell, COVID-19 patient, dysregulation, blood sample, syndrome, Stage, cellular interactions, responses, immunological, the disease, required, characterized, activated, changes in, modulate, reveal, co-regulated, diagnosed with COVID-19, 【제목키워드】 phase,