Zhang, J-Y; Wang, X-M; Xing, X; Xu, Z; Zhang, C; Song, J-W; Fan, X; ... Wang, F-S; + view all Zhang, J-Y; Wang, X-M; Xing, X; Xu, Z; Zhang, C; Song, J-W; Fan, X; Xia, P; Fu, J-L; Wang, S-Y; Xu, R-N; Dai, X-P; Shi, L; Huang, L; Jiang, T-J; Shi, M; Zhang, Y; Zumla, A; Maeurer, M; Bai, F; Wang, F-S; - view fewer (2020) Single-cell landscape of immunological responses in patients with COVID-19. Nature Immunology , 21 (9) pp. 1107-1118. 10.1038/s41590-020-0762-x.

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Abstract

In coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the relationship between disease severity and the host immune response is not fully understood. Here we performed single-cell RNA sequencing in peripheral blood samples of 5 healthy donors and 13 patients with COVID-19, including moderate, severe and convalescent cases. Through determining the transcriptional profiles of immune cells, coupled with assembled T cell receptor and B cell receptor sequences, we analyzed the functional properties of immune cells. Most cell types in patients with COVID-19 showed a strong interferon-α response and an overall acute inflammatory response. Moreover, intensive expansion of highly cytotoxic effector T cell subsets, such as CD4^{+} effector-GNLY (granulysin), CD8^{+} effector-GNLY and NKT CD160, was associated with convalescence in moderate patients. In severe patients, the immune landscape featured a deranged interferon response, profound immune exhaustion with skewed T cell receptor repertoire and broad T cell expansion. These findings illustrate the dynamic nature of immune responses during disease progression.

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