Journal
NATURE IMMUNOLOGY
Volume 21, Issue 9, Pages 1107-+Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41590-020-0762-x
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Funding
- National Key Research and Development Program of China from the Ministry of Science and Technology of China [2020YFC0841900, 2020YFC0844000]
- European and Developing Countries Clinical Trials Partnership
- UK NIHR Senior Investigator Award
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In coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the relationship between disease severity and the host immune response is not fully understood. Here we performed single-cell RNA sequencing in peripheral blood samples of 5 healthy donors and 13 patients with COVID-19, including moderate, severe and convalescent cases. Through determining the transcriptional profiles of immune cells, coupled with assembled T cell receptor and B cell receptor sequences, we analyzed the functional properties of immune cells. Most cell types in patients with COVID-19 showed a strong interferon-alpha response and an overall acute inflammatory response. Moreover, intensive expansion of highly cytotoxic effector T cell subsets, such as CD4(+)effector-GNLY (granulysin), CD8(+)effector-GNLY and NKT CD160, was associated with convalescence in moderate patients. In severe patients, the immune landscape featured a deranged interferon response, profound immune exhaustion with skewed T cell receptor repertoire and broad T cell expansion. These findings illustrate the dynamic nature of immune responses during disease progression. Severe COVID-19 is characterized-among other things-by a hyperinflammatory state. Wang and colleagues describe the single-cell transcriptional landscape of moderate, severe and convalescent cases of patients with COVID-19.
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