Low T Cell Responsiveness in the Early Phase Of COVID-19 Associates with Progression to Severe Pneumonia in Kidney Transplant Recipients
M. Cremoni1, S. Cuozzo1, E. Martinuzzi2, S. Barbosa2, N. Ben Hassen1, F. Massa3, E. Demonchy4, M. Durand5, O. Thaunat6, V. Esnault1, M. Lequintrec7, S. Caillard8, N. Glaichenhaus2, A. Sicard1
1Service de Néphrologie, Dialyse, Transplantation rénale, Centre Hospitalier Universitaire de Nice, Nice, France, 2CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France, 3Université Côte d'Azur, Laboratoire de Physio-Médecine Moléculaire, Nice, France, 4Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France, 5Service d'Urologie, Centre Hospitalier Universitaire de Nice, Nice, France, 6Service de Transplantation rénale, Néphrologie et Immunologie clinique, Hôpital Edouard Herriot, Hospices civils de Lyon, Lyon, France, 7Service de Néphrologie, Dialyse, Transplantation rénale, Centre Hospitalier Universitaire Lapeyronie, Montpellier, France, 8Service de Néphrologie et Transplantation, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
Meeting: 2022 American Transplant Congress
Abstract number: 250
Keywords: COVID-19, Immunosuppression, Kidney transplantation, T cell reactivity
Topic: Clinical Science » Infection Disease » 24 - All Infections (Excluding Kidney & Viral Hepatitis)
Session Information
Session Name: COVID-19 Infections Part 2: All Organs
Session Type: Rapid Fire Oral Abstract
Date: Monday, June 6, 2022
Session Time: 3:30pm-5:00pm
Presentation Time: 4:40pm-4:50pm
Location: Hynes Ballroom B
*Purpose: Kidney transplant (KT) recipients are more prone to developing life-threatening forms of COVID-19 than the general population. Little is known about the immunological mechanisms underlying disease severity in these patients receiving T-cell targeting immunosuppressive drugs. We investigated the relationship between T cell responsiveness at the beginning of the infection and the risk to subsequently progress to respiratory failure.
*Methods: We performed a multicentric prospective study in 45 KT recipients with a positive RT-PCR COVID-19 test and only mild symptoms at inclusion. Blood samples were collected at baseline directly in a cell culture system containing T cell stimuli. We assessed T cell responsiveness by computing the ratio between the levels of Th1, Th2, Th17 and Treg cytokines produced after polyclonal stimulation and the number of blood lymphocytes. We then used an unsupervised classification approach to stratify patients into low and high T cell responders and a penalized logistic regression to identify variables independently associated with progression to severe COVID-19.
*Results: Forty-five kidney transplant patients were included. Unsupervised clusterization identified 31 low and 14 high T cell responders. Patients who progressed to severe pneumonia were all low T cell responders (p=0.01). In multivariate analysis, we found that low T cell responsiveness at baseline was the main risk factor for subsequent progression to severe pneumonia.
*Conclusions: Low T cell reactivity in the early phase of COVID-19 is strongly associated with progression to severe pneumonia. This study provides new insights into the mechanisms underlying COVID-19 severity in organ transplant recipients and data of interest to clinicians managing immunosuppressive drugs in these patients.
To cite this abstract in AMA style:
Cremoni M, Cuozzo S, Martinuzzi E, Barbosa S, Hassen NBen, Massa F, Demonchy E, Durand M, Thaunat O, Esnault V, Lequintrec M, Caillard S, Glaichenhaus N, Sicard A. Low T Cell Responsiveness in the Early Phase Of COVID-19 Associates with Progression to Severe Pneumonia in Kidney Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/low-t-cell-responsiveness-in-the-early-phase-of-covid-19-associates-with-progression-to-severe-pneumonia-in-kidney-transplant-recipients/. Accessed September 7, 2024.« Back to 2022 American Transplant Congress