Profiling of immune dysfunction in COVID-19 patients allows early prediction of disease progression

André F. Rendeiro, Joseph Casano, Charles Kyriakos Vorkas, Harjot Singh, Ayana Morales, Robert A. DeSimone, Grant B. Ellsworth, Rosemary Soave, Shashi N. Kapadia, Kohta Saito, Christopher D. Brown, Jing Mei Hsu, Christopher Kyriakides, Steven Chiu, Luca Vincenzo Cappelli, Maria Teresa Cacciapuoti, Wayne Tam, Lorenzo Galluzzi, Paul D. Simonson, Olivier ElementoMirella Salvatore, Giorgio Inghirami

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


With a rising incidence of COVID-19-associated morbidity and mortality worldwide, it is critical to elucidate the innate and adaptive immune responses that drive disease severity. We performed longitudinal immune profiling of peripheral blood mononuclear cells from 45 patients and healthy donors. We observed a dynamic immune landscape of innate and adaptive immune cells in disease progression and absolute changes of lymphocyte and myeloid cells in severe versus mild cases or healthy controls. Intubation and death were coupled with selected natural killer cell KIR receptor usage and IgM+ B cells and associated with profound CD4 and CD8 T-cell exhaustion. Pseudo-temporal reconstruction of the hierarchy of disease progression revealed dynamic time changes in the global population recapitulating individual patients and the development of an eight-marker classifier of disease severity. Estimating the effect of clinical progression on the immune response and early assessment of disease progression risks may allow implementation of tailored therapies.

Original languageEnglish
Article numbere202000955
JournalLife Science Alliance
Issue number2
StatePublished - Feb 2021
Externally publishedYes


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