Phenotype of SARS-CoV-2-specific T-cells in COVID-19 patients with acute respiratory distress syndrome

Daniela Weiskopf; Katharina S. Schmitz; Matthijs P. Raadsen; Alba Grifoni; Nisreen M.A. Okba; Henrik Endeman; Johannes P.C. van den Akker; Richard Molenkamp; Marion P.G. Koopmans; Eric C.M. van Gorp; Bart L. Haagmans; Rik L. de Swart; Alessandro Sette; Rory Dylan de Vries

A novel coronavirus, named SARS-CoV-2, has been identified as the causative agent of a global outbreak of respiratory tract disease (COVID-19) 1,2 . On April 9 th , over 1.5 million cases and more than 90,000 deaths were reported globally. COVID-19 is characterized by fever, cough, dyspnea and myalgia 2 , but in some patients the infection results in moderate to severe acute respiratory distress syndrome (ARDS), requiring invasive mechanical ventilation for a period of several weeks. COVID-19 patients may present with lymphopenia 2,3 , but the disease has also been associated with immune hyperresponsiveness referred to as 'cytokine storm' 4 . A transient increase in co-expression of CD38 and HLA-DR by T-cells, a phenotype of CD8 + Tcell activation in response to viral infection, was observed concomitantly 5 . This increase in both CD4 + and CD8 + CD38 + HLA-DR + T-cells preceded resolution of clinical symptoms in a non-severe, recovered, COVID-19 patient 6 .