Persistent T cell phenotypic alterations and early innate immune dysregulation as potential biomarkers of Long COVID, 2026, Perez-Mazzali+

SNT Gatchaman

Senior Member (Voting Rights)
Staff member
Persistent T cell phenotypic alterations and early innate immune dysregulation as potential biomarkers of Long COVID
Marina Perez-Mazzali; Francisco Pérez-Cózar; Paloma Cal-Sabater; Paulina Rybakowska; Pablo Tellería; Javier Gamazo; Marina G De Vicuña; Elisa Arribas-Rodríguez; Aida Fiz-López; Carolina G de Castro; Antonio García-Blesa; Silvia Rojo Rello; Ángel De Prado; Cándido Pérez; Eduardo Tamayo; Antonio Orduña; Carlos Dueñas; Concepción Marañón; David Bernardo; Sara Cuesta-Sancho

Long COVID is a complex condition characterized by a broad spectrum of persistent, multisystemic symptoms that often impair daily activities and cause disability with significant socioeconomic impact. Although several hypotheses have been proposed to explain its pathophysiology—including immune dysregulation—the underlying mechanisms remain poorly understood. Indeed, there are no current treatments for this condition. Therefore, we aimed to characterize immune alterations induced by SARS-CoV-2 during the acute phase of infection and three months post-hospital discharge in a cohort of patients who later developed Long COVID, referred to a matched cohort who did not.

We performed high-dimensional immune profiling of peripheral blood mononuclear cells using a 40-marker mass cytometry panel. Data analysis combined classical hierarchical gating strategies with unsupervised computational approaches. Our results revealed distinct immune signatures between Long COVID and non-Long COVID patients, affecting both the innate and adaptive immune compartments.

Notably, individuals who subsequently developed Long COVID exhibited early abnormalities at infection in innate immunity, particularly involving dendritic cells and γδ T cells. Moreover, three months post-discharge, persistent alterations were observed in several adaptive immune cell subsets in patients who next developed Long COVID over time.

In summary, our findings suggest that early immune dysregulation following viral infection may predispose individuals to persistent post-viral pathology.

HIGHLIGHTS
• High-dimensional cytometry reveals a distinct immune profile for Long COVID patients

• Early disruption of the immune system affects dendritic cells and γδ T cells

• Several T cell subsets are dysregulated 3 months post infection in Long COVID patients

• Immune imbalance at initial stages may predispose to persistent post-viral pathology

Web | DOI | PDF | Journal of Infection | Open Access
 
Persistent T cell phenotypic alterations and early innate immune dysregulation as potential biomarkers of Long COVID
Marina Perez-Mazzali; Francisco Pérez-Cózar; Paloma Cal-Sabater; Paulina Rybakowska; Pablo Tellería; Javier Gamazo; Marina G De Vicuña; Elisa Arribas-Rodríguez; Aida Fiz-López; Carolina G de Castro; Antonio García-Blesa; Silvia Rojo Rello; Ángel De Prado; Cándido Pérez; Eduardo Tamayo; Antonio Orduña; Carlos Dueñas; Concepción Marañón; David Bernardo; Sara Cuesta-Sancho

Long COVID is a complex condition characterized by a broad spectrum of persistent, multisystemic symptoms that often impair daily activities and cause disability with significant socioeconomic impact. Although several hypotheses have been proposed to explain its pathophysiology—including immune dysregulation—the underlying mechanisms remain poorly understood. Indeed, there are no current treatments for this condition. Therefore, we aimed to characterize immune alterations induced by SARS-CoV-2 during the acute phase of infection and three months post-hospital discharge in a cohort of patients who later developed Long COVID, referred to a matched cohort who did not.

We performed high-dimensional immune profiling of peripheral blood mononuclear cells using a 40-marker mass cytometry panel. Data analysis combined classical hierarchical gating strategies with unsupervised computational approaches. Our results revealed distinct immune signatures between Long COVID and non-Long COVID patients, affecting both the innate and adaptive immune compartments.

Notably, individuals who subsequently developed Long COVID exhibited early abnormalities at infection in innate immunity, particularly involving dendritic cells and γδ T cells. Moreover, three months post-discharge, persistent alterations were observed in several adaptive immune cell subsets in patients who next developed Long COVID over time.

In summary, our findings suggest that early immune dysregulation following viral infection may predispose individuals to persistent post-viral pathology.

HIGHLIGHTS
• High-dimensional cytometry reveals a distinct immune profile for Long COVID patients

• Early disruption of the immune system affects dendritic cells and γδ T cells

• Several T cell subsets are dysregulated 3 months post infection in Long COVID patients

• Immune imbalance at initial stages may predispose to persistent post-viral pathology

Web | DOI | PDF | Journal of Infection | Open Access
I think studies like these are using the prime opportunity of having the ability to track post viral illness from the get go for once. This one is an important contribution I’d wager. If we understand which acute immune profiles predisposed people to longer sequela, that might teach us where to look even later on.
 
My suspicion is that if you need this sort of complicated statistical analysis to show patterns you are very likely to pick out things by chance. I don't see any clear immunological story here.
 
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