Systems-level immunomonitoring from acute to recovery phase of severe COVID-19

Rodriguez, Lucie; Pekkarinen, Pirkka T.; Lakshmikanth, Tadepally; Tan, Ziyang; Consiglio, Camila Rosat; Pou, Christian; Chen, Yang; Mugabo, Constantin Habimana; Nguyen, Ngoc Anh; Nowlan, Kirsten; Strandin, Tomas; Levanov, Lev; Mikes, Jaromir; Wang, Jun; Kantele, Anu; Hepojoki, Jussi; Vapalahti, Olli; Heinonen, Santtu; Kekäläinen, Eliisa; Brodin, Petter

Summary Severe disease of SARS-CoV2 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 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 prior to lung hyperinflammation and changes in cell-cell coregulation during different stages of the disease. We also map an immune trajectory during recovery that is shared among patients with severe COVID-19.