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 May 18, 2025.

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