Frontiers in Immunology (Dec 2020)
Different Innate and Adaptive Immune Responses to SARS-CoV-2 Infection of Asymptomatic, Mild, and Severe Cases
- Rita Carsetti,
- Rita Carsetti,
- Salvatore Zaffina,
- Salvatore Zaffina,
- Eva Piano Mortari,
- Sara Terreri,
- Francesco Corrente,
- Claudia Capponi,
- Patrizia Palomba,
- Mattia Mirabella,
- Simona Cascioli,
- Paolo Palange,
- Ilaria Cuccaro,
- Cinzia Milito,
- Alimuddin Zumla,
- Alimuddin Zumla,
- Markus Maeurer,
- Markus Maeurer,
- Vincenzo Camisa,
- Vincenzo Camisa,
- Maria Rosaria Vinci,
- Maria Rosaria Vinci,
- Annapaola Santoro,
- Annapaola Santoro,
- Eleonora Cimini,
- Luisa Marchioni,
- Emanuele Nicastri,
- Fabrizio Palmieri,
- Chiara Agrati,
- Giuseppe Ippolito,
- Ottavia Porzio,
- Ottavia Porzio,
- Carlo Concato,
- Andrea Onetti Muda,
- Massimiliano Raponi,
- Concetta Quintarelli,
- Concetta Quintarelli,
- Isabella Quinti,
- Franco Locatelli,
- Franco Locatelli
Affiliations
- Rita Carsetti
- B Cell Pathophysiology Unit, Immunology Research Area, Bambino Gesù Children’s Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS), Rome, Italy
- Rita Carsetti
- Diagnostic Immunology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Salvatore Zaffina
- Occupational Medicine/Health Technology Assessment and Safety Research Unit, Clinical-Technological Innovations Research Area, Bambino Gesù Children’s Hospital, IRCSS, Rome, Italy
- Salvatore Zaffina
- Health Directorate, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Eva Piano Mortari
- B Cell Pathophysiology Unit, Immunology Research Area, Bambino Gesù Children’s Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS), Rome, Italy
- Sara Terreri
- B Cell Pathophysiology Unit, Immunology Research Area, Bambino Gesù Children’s Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS), Rome, Italy
- Francesco Corrente
- Diagnostic Immunology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Claudia Capponi
- Diagnostic Immunology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Patrizia Palomba
- Diagnostic Immunology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Mattia Mirabella
- Diagnostic Immunology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Simona Cascioli
- Research Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Paolo Palange
- Department of Public Health and Infectious Diseases Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy
- Ilaria Cuccaro
- Department of Public Health and Infectious Diseases Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy
- Cinzia Milito
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- Alimuddin Zumla
- Center for Clinical Microbiology, Division of Infection and Immunity, University College London, London, United Kingdom
- Alimuddin Zumla
- NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
- Markus Maeurer
- 0Immunotherapy Programme, Champalimaud Foundation, Lisbon, Portugal
- Markus Maeurer
- 1Med Clinic, University of Mainz, Mainz, Germany
- Vincenzo Camisa
- Occupational Medicine/Health Technology Assessment and Safety Research Unit, Clinical-Technological Innovations Research Area, Bambino Gesù Children’s Hospital, IRCSS, Rome, Italy
- Vincenzo Camisa
- Health Directorate, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Maria Rosaria Vinci
- Occupational Medicine/Health Technology Assessment and Safety Research Unit, Clinical-Technological Innovations Research Area, Bambino Gesù Children’s Hospital, IRCSS, Rome, Italy
- Maria Rosaria Vinci
- Health Directorate, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Annapaola Santoro
- Occupational Medicine/Health Technology Assessment and Safety Research Unit, Clinical-Technological Innovations Research Area, Bambino Gesù Children’s Hospital, IRCSS, Rome, Italy
- Annapaola Santoro
- Health Directorate, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Eleonora Cimini
- 2Cellular Immunology Laboratory, INMI L Spallanzani, IRCCS, Rome, Italy
- Luisa Marchioni
- 3Clinical Department, INMI L Spallanzani, IRCCS, Rome, Italy
- Emanuele Nicastri
- 3Clinical Department, INMI L Spallanzani, IRCCS, Rome, Italy
- Fabrizio Palmieri
- 3Clinical Department, INMI L Spallanzani, IRCCS, Rome, Italy
- Chiara Agrati
- 2Cellular Immunology Laboratory, INMI L Spallanzani, IRCCS, Rome, Italy
- Giuseppe Ippolito
- 4Scientific Direction, INMI L Spallanzani, IRCCS, Rome, Italy
- Ottavia Porzio
- 5Medical Laboratory Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Ottavia Porzio
- 6Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
- Carlo Concato
- 7Virology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Andrea Onetti Muda
- 8Department of Laboratories, Bambino Gesù Children’s Hospital, Rome, Italy
- Massimiliano Raponi
- Health Directorate, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Concetta Quintarelli
- 9Department of Hematology/Oncology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Concetta Quintarelli
- 0Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Isabella Quinti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- Franco Locatelli
- 9Department of Hematology/Oncology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Franco Locatelli
- 1Department of Pediatrics, Sapienza, University of Rome, Rome, Italy
- DOI
- https://doi.org/10.3389/fimmu.2020.610300
- Journal volume & issue
-
Vol. 11
Abstract
SARS-CoV-2 is a novel coronavirus, not encountered before by humans. The wide spectrum of clinical expression of SARS-CoV-2 illness suggests that individual immune responses to SARS-CoV-2 play a crucial role in determining the clinical course after first infection. Immunological studies have focused on patients with moderate to severe disease, demonstrating excessive inflammation in tissues and organ damage. In order to understand the basis of the protective immune response in COVID-19, we performed a longitudinal follow-up, flow-cytometric and serological analysis of innate and adaptive immunity in 64 adults with a spectrum of clinical presentations: 28 healthy SARS-CoV-2-negative contacts of COVID-19 cases; 20 asymptomatic SARS-CoV-2-infected cases; eight patients with Mild COVID-19 disease and eight cases of Severe COVID-19 disease. Our data show that high frequency of NK cells and early and transient increase of specific IgA, IgM and, to a lower extent, IgG are associated with asymptomatic SARS-CoV-2 infection. By contrast, monocyte expansion and high and persistent levels of IgA and IgG, produced relatively late in the course of the infection, characterize severe disease. Modest increase of monocytes and different kinetics of antibodies are detected in mild COVID-19. The importance of innate NK cells and the short-lived antibody response of asymptomatic individuals and patients with mild disease suggest that only severe COVID-19 may result in protective memory established by the adaptive immune response.
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