Polyfunctional T-cell impairment to SARS-CoV-2 coronavirus in solid organ transplant recipients with acute COVID-19 infection

ABSTRACT

Purpose: The emerged COVID-19 pandemic caused by SARS-CoV-2 has paralyzed the world, due to its high infectivity and fatal outcomes, especially among more vulnerable individuals. While description of protective humoral and T-cell immune responses has been reported among immunocompetent (IC) individuals, its characterization and determinants of poorer outcomes among the at-risk Solid Organ Transplant (SOT) patient population has not been thoroughly investigated. Methods: SARS-CoV-2-specific serological and functional T-cell immune responses against main immunogenic antigens were tracked in 28 SOT recipients during acute infection and over the following 40 days of convalescence and were compared to 16 IC patients admitted with similar moderate/severe COVID-19. Results: We show a more severe polyfunctional T-cell and serological impairment in SOT at the infection onset as compared to IC individuals, especially against membrane antigen. Worse clinical outcomes (need of mechanical ventilation or death) more frequently occurred within SOT and were associated with a significantly impaired Th1 polarized immune response to antigens spike and membrane. Nonetheless, SOT achieved robust serological and functional Th1 and Th2 immune responses at convalescence, similarly to those of IC patients. Conclusions: Our data show a delay of serological and functional T-cell immune activation to SARS-CoV-2 in SOT, which may entail poorer clinical outcomes.