TY - JOUR
T1 - A short corticosteroid course reduces symptoms and immunological alterations underlying long-COVID
AU - Utrero-Rico, Alberto
AU - Ruiz-Ruigómez, María
AU - Laguna-Goya, Rocío
AU - Arrieta-Ortubay, Estíbaliz
AU - Chivite-Lacaba, Marta
AU - González-Cuadrado, Cecilia
AU - Lalueza, Antonio
AU - Almendro-Vazquez, Patricia
AU - Serrano, Antonio
AU - Aguado, José María
AU - Lumbreras, Carlos
AU - Paz-Artal, Estela
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/11
Y1 - 2021/11
N2 - Despite the growing number of patients with persistent symptoms after acute SARS-CoV-2 infection, the pathophysiology underlying long-COVID is not yet well characterized, and there is no established therapy. We performed a deep immune profiling in nine patients with persistent symptoms (PSP), before and after a 4-day prednisone course, and five post-COVID-19 patients without persistent symptoms (NSP). PSP showed a perturbed distribution of circulating mononuclear cell populations. Symptoms in PSP were accompanied by a pro-inflammatory phenotype characterized by increased conventional dendritic cells and augmented expression of antigen presentation, co-stimulation, migration, and activation markers in monocytes. The adaptive immunity compartment in PSP showed a Th1-predominance, decreased naïve and regulatory T cells, and augmentation of the PD-1 exhaustion marker. These immune alterations reverted after the corticosteroid treatment and were maintained during the 4-month follow-up, and their normalization correlated with clinical amelioration. The current work highlights an immunopathogenic basis together with a possible role for steroids in the treatment for long-COVID.
AB - Despite the growing number of patients with persistent symptoms after acute SARS-CoV-2 infection, the pathophysiology underlying long-COVID is not yet well characterized, and there is no established therapy. We performed a deep immune profiling in nine patients with persistent symptoms (PSP), before and after a 4-day prednisone course, and five post-COVID-19 patients without persistent symptoms (NSP). PSP showed a perturbed distribution of circulating mononuclear cell populations. Symptoms in PSP were accompanied by a pro-inflammatory phenotype characterized by increased conventional dendritic cells and augmented expression of antigen presentation, co-stimulation, migration, and activation markers in monocytes. The adaptive immunity compartment in PSP showed a Th1-predominance, decreased naïve and regulatory T cells, and augmentation of the PD-1 exhaustion marker. These immune alterations reverted after the corticosteroid treatment and were maintained during the 4-month follow-up, and their normalization correlated with clinical amelioration. The current work highlights an immunopathogenic basis together with a possible role for steroids in the treatment for long-COVID.
KW - Corticosteroids
KW - Immunological alterations
KW - Long-COVID
UR - https://www.scopus.com/pages/publications/85118347268
U2 - 10.3390/biomedicines9111540
DO - 10.3390/biomedicines9111540
M3 - Article
AN - SCOPUS:85118347268
SN - 2227-9059
VL - 9
JO - Biomedicines
JF - Biomedicines
IS - 11
M1 - 1540
ER -