The immune response to SARS-CoV2 is under intense investigation, but not fully understood att this moment. Severe disease is characterized by vigorous inflammatory responses in the lung, often with a sudden onset after 5-7 days of stable disease. Efforts to modulate this hyperinflammation and the associated acute respiratory distress syndrome, rely on the unraveling of the immune cell interactions and cytokines that drive such responses. Systems-level analyses are required to simultaneously capture all immune cell populations and the many protein mediators by which cells communicate. Since every patient analyzed will be captured at different stages of his or her infection, longitudinal monitoring of the immune response is critical. Here we report on a systems-level blood immunomonitoring study of 39 adult patients, hospitalized with severe COVID-19 and followed with up to 14 blood samples from acute to recovery phases of the disease. We describe an IFNg-Eosinophil axis activated prior to lung hyperinflammation and changes in cell-cell coregulation during different stages of the disease. We also map an immune trajectory during recovery that is shared among patients with severe COVID-19.

中文翻译：

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重度COVID-19从急性期到恢复期的系统级免疫监测

对SARS-CoV2的免疫反应正在深入研究中，但此刻尚未完全了解。严重疾病的特征是肺部剧烈炎症反应，在稳定疾病持续5-7天后通常会突然发作。调节这种过度炎症和相关的急性呼吸窘迫综合征的努力依赖于解开驱动这种反应的免疫细胞相互作用和细胞因子。需要进行系统级分析才能同时捕获所有免疫细胞群和细胞之间进行交流的许多蛋白质介体。由于每个被分析的患者都将在其感染的不同阶段被捕获，因此纵向监测免疫反应至关重要。在这里，我们对39名成年患者进行了系统级血液免疫监测研究，接受重度COVID-19的住院治疗，随后从该疾病的急性期到恢复期进行多达14份血液采样。我们描述了一个IFNg-嗜酸细胞轴激活之前肺过度炎症和疾病的不同阶段中细胞-细胞凝集的变化。我们还绘制了重症患者COVID-19共享的康复过程中的免疫轨迹。