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Critically ill SARS-CoV-2 patients display lupus-like hallmarks of extrafollicular B cell activation
Preprint
in En
| PREPRINT-MEDRXIV
| ID: ppmedrxiv-20083717
ABSTRACT
Abstract/IntroductionA wide clinical spectrum has become a hallmark of the SARS-CoV-2 (COVID-19) pandemic, although its immunologic underpinnings remain to be defined. We have performed deep characterization of B cell responses through high-dimensional flow cytometry to reveal substantial heterogeneity in both effector and immature populations. More notably, critically ill patients displayed hallmarks of extrafollicular B cell activation as previously described in autoimmune settings. Extrafollicular activation correlated strongly with large antibody secreting cell expansion and early production of high levels of SARS-CoV-2-specific antibodies. Yet, these patients fared poorly with elevated inflammatory biomarkers, multi-organ failure, and death. Combined, the findings strongly indicate a major pathogenic role for immune activation in subsets of COVID-19 patients. Our study suggests that, as in autoimmunity, targeted immunomodulatory therapy may be beneficial in specific patient subpopulations that can be identified by careful immune profiling.
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Full text:
1
Collection:
09-preprints
Database:
PREPRINT-MEDRXIV
Type of study:
Prognostic_studies
Language:
En
Year:
2020
Document type:
Preprint