ABSTRACT
COVID-19 affects the population unequally with a higher impact on aged and immunosuppressed people. Hence, we assessed the effect of SARS-CoV-2 vaccination in immune compromised patients (older adults and oncohematologic patients), compared with healthy counterparts. While the acquired humoral and cellular memory did not predict subsequent infection 18 months after full immunization, spectral and computational cytometry revealed several subsets within the CD8+ T-cells, B-cells, NK cells, monocytes and CD45RA+CCR7- T{gamma}{delta} cells differentially expressed in further infected and non-infected individuals not just following immunization, but also prior to that. Of note up to 7 subsets were found within the CD45RA+CCR7- T{gamma}{delta} population with some of them being expanded and other decreased in subsequently infected individuals. Moreover, some of these subsets also predicted COVID-induced hospitalization in oncohematologic patients. Therefore, we hereby have identified several cellular subsets that, even before vaccination, strongly related to COVID-19 vulnerability as opposed to the acquisition of cellular and/or humoral memory following vaccination with SARS-CoV-2 mRNA vaccines.
Subject(s)
COVID-19 , LymphomaABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. However, long-term clinical, functional, and metabolic consequences are still unknown. This study sought to identify clinical sequelae and its potential intrinsic mechanism among COVID-19 survivors in the follow-up. Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up, an outpatient asymptomatic control group was also evaluated. They underwent serial testing with cardio-pulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis and quality of life questionaries.Results: Patients with dyspnea (n=41, 58.6%), compared with asymptomatic (n=29, 41.4%), had a higher proportion of females (73.2% vs. 51.7%; p= 0.065), with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in transthoracic echocardiogram and pulmonary function test, in either group. Patients who referred dyspnea had a significant decline in predicted peak O2 consumption (77.8 [64-92.5] vs. 99 [88-105]: p<0.00; p<0.001), total distance in the 6-minute walking test (535 [467-600] vs. 611 [550-650] meters; p= 0.001), and quality of life (KCCQ-23 60.1±18.6 vs. 82.8±11.3; p<0.001). Additionally, abnormalities in CPET were suggestive of a ventilation/perfusion characterized by impaired ventilatory efficiency (VE/VCO2 slope 32 [28.1-37.4] vs. 29.4 [26.9-31.4]; p= 0.022) and low O2 pulse (9.2 [7.3-11.3] vs. 10.6 [8.7-13.2]; p= 0.013). Interpretation: In this study >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest potential ventilation/perfusion mismatch.Funding Statement: The present study was partially granted by Gerencia Regional de Salud de Castilla y León under grant number GRS COVID 111/A/20 and Grant from the Spanish Society of Cardiology: SEC/FEC-INVCLI 20/030Declaration of Interests: None.Ethics Approval Statement: The institutional local ethics committees approved the study protocol (CASVE PI-20-1894) and all patients provided written informed consent before inclusion.