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Early immune markers of clinical, virological, and immunological outcomes in patients with COVID-19: a multi-omics study

  • Zicheng Hu
  • , Kattria van der Ploeg
  • , Saborni Chakraborty
  • , Prabhu S. Arunachalam
  • , Diego A.M. Mori
  • , Karen B. Jacobson
  • , Hector Bonilla
  • , Julie Parsonnet
  • , Jason R. Andrews
  • , Marisa Holubar
  • , Aruna Subramanian
  • , Chaitan Khosla
  • , Yvonne Maldonado
  • , Haley Hedlin
  • , Lauren de la Parte
  • , Kathleen Press
  • , Maureen Ty
  • , Gene S. Tan
  • , Catherine Blish
  • , Saki Takahashi
  • Isabel Rodriguez-Barraquer, Bryan Greenhouse, Atul J. Butte, Upinder Singh, Bali Pulendran, Taia T. Wang, Prasanna Jagannathan

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background: The great majority of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infections are mild and uncomplicated, but some individuals with initially mild COVID-19 progressively develop more severe symptoms. Furthermore, there is substantial heterogeneity in SARS-CoV-2-specific memory immune responses following infection. There remains a critical need to identify host immune biomarkers predictive of clinical and immunological outcomes in SARS-CoV-2-infected patients. Methods: Leveraging longitudinal samples and data from a clinical trial (N=108) in SARS-CoV-2-infected outpatients, we used host proteomics and transcriptomics to characterize the trajectory of the immune response in COVID-19 patients. We characterized the association between early immune markers and subsequent disease progression, control of viral shedding, and SARS-CoV-2-specific T cell and antibody responses measured up to 7 months after enrollment. We further compared associations between early immune markers and subsequent T cell and antibody responses following natural infection with those following mRNA vaccination. We developed machine-learning models to predict patient outcomes and validated the predictive model using data from 54 individuals enrolled in an independent clinical trial. Results: We identify early immune signatures, including plasma RIG-I levels, early IFN signaling, and related cytokines (CXCL10, MCP1, MCP-2, and MCP-3) associated with subsequent disease progres-sion, control of viral shedding, and the SARS-CoV-2-specific T cell and antibody response measured up to 7 months after enrollment. We found that several biomarkers for immunological outcomes are shared between individuals receiving BNT162b2 (Pfizer–BioNTech) vaccine and COVID-19 patients. Finally, we demonstrate that machine-learning models using 2–7 plasma protein markers measured early within the course of infection are able to accurately predict disease progression, T cell memory, and the antibody response post-infection in a second, independent dataset. Conclusions: Early immune signatures following infection can accurately predict clinical and immunological outcomes in outpatients with COVID-19 using validated machine-learning models.

Original languageEnglish
Article numbere77943
JournaleLife
Volume11
DOIs
StatePublished - Oct 2022
Externally publishedYes

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