Summary
The COVID-19 pandemic caused by SARS-CoV2 is characterized by a remarkable variation in clinical severity ranging from a mild illness to a fatal multi-organ disease. Understanding the dysregulated human immune responses in the fatal subjects is critical for management of COVID-19 patients and the pandemic. In this study, we examined the immune cell compositions in the lung tissues and hilar lymph nodes using immunohistochemistry on 6 deceased COVID-19 patients and 4 focal organizing pneumonia (FOP) patients who underwent lung surgery and served as controls. We found a dominant presence of macrophages and a general deficiency of T cells and B cells in the lung tissues from deceased COVID-19 patients. In contrast to the FOP patients, Tfh cells and germinal center formation were largely absent in the draining hilar lymph nodes in the deceased COVID-19 patients. This was correlated with reduced IgM and IgG levels compared to convalescent COVID-19 patients. In summary, our data highlight a defect of germinal center structure in deceased COVID-19 patients leading to an impaired humoral immunity. Understanding the mechanisms of this deficiency will be one of the key points for the management of this epidemic.
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Acknowledgments
We would like to thank Dr. Arian Laurence for critical input for the conceptualization of the project and writing of the manuscript and Dr. Ran He for critical reading of the manuscript.
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The study was funded by grants from the Special R&D Program of Ministry of Science and Technology (No. 2019YFC1316203), Ministry of Science and Technology (No. 2020YFC0844700), Clinical Foundation of Tongji Hospital (No. XXGZBDYJ010).
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Duan, Yq., Xia, Mh., Ren, L. et al. Deficiency of Tfh Cells and Germinal Center in Deceased COVID-19 Patients. CURR MED SCI 40, 618–624 (2020). https://doi.org/10.1007/s11596-020-2225-x
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DOI: https://doi.org/10.1007/s11596-020-2225-x