Frontiers in Medicine (Jun 2022)

Longitudinal Analysis of Biologic Correlates of COVID-19 Resolution: Case Report

  • Natalie Bruiners,
  • Natalie Bruiners,
  • Valentina Guerrini,
  • Valentina Guerrini,
  • Rahul Ukey,
  • Ryan J. Dikdan,
  • Jason H. Yang,
  • Jason H. Yang,
  • Pankaj Kumar Mishra,
  • Alberta Onyuka,
  • Deborah Handler,
  • Joshua Vieth,
  • Mary Carayannopoulos,
  • Shuang Guo,
  • Maressa Pollen,
  • Abraham Pinter,
  • Abraham Pinter,
  • Sanjay Tyagi,
  • Sanjay Tyagi,
  • Daniel Feingold,
  • Claire Philipp,
  • Steven K. Libutti,
  • Maria Laura Gennaro,
  • Maria Laura Gennaro

DOI
https://doi.org/10.3389/fmed.2022.915367
Journal volume & issue
Vol. 9

Abstract

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While the biomarkers of COVID-19 severity have been thoroughly investigated, the key biological dynamics associated with COVID-19 resolution are still insufficiently understood. We report a case of full resolution of severe COVID-19 due to convalescent plasma transfusion. Following transfusion, the patient showed fever remission, improved respiratory status, and rapidly decreased viral burden in respiratory fluids and SARS-CoV-2 RNAemia. Longitudinal unbiased proteomic analysis of plasma and single-cell transcriptomics of peripheral blood cells conducted prior to and at multiple times after convalescent plasma transfusion identified the key biological processes associated with the transition from severe disease to disease-free state. These included (i) temporally ordered upward and downward changes in plasma proteins reestablishing homeostasis and (ii) post-transfusion disappearance of a subset of monocytes characterized by hyperactivated Interferon responses and decreased TNF-α signaling. Monitoring specific dysfunctional myeloid cell subsets in peripheral blood may provide prognostic keys in COVID-19.

Keywords