COVID-19 patients share common, corticosteroid-independent features of impaired host immunity to pathogenic molds.


Patients suffering from coronavirus disease-2019 (COVID-19) are susceptible to deadly secondary fungal infections such as COVID-19-associated pulmonary aspergillosis and COVID-19-associated mucormycosis. Despite this clinical observation, direct experimental evidence for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)-driven alterations of antifungal immunity is scarce. Using an ex-vivo whole blood stimulation assay, we challenged blood from twelve COVID-19 patients with Aspergillus fumigatus and Rhizopus arrhizus antigens and studied the expression of activation, maturation, and exhaustion markers, as well as cytokine secretion. Compared to healthy controls, T-helper cells from COVID-19 patients displayed increased expression levels of the exhaustion marker PD-1 and weakened A. fumigatus- and R. arrhizus-induced activation. While baseline secretion of proinflammatory cytokines was massively elevated, whole blood from COVID-19 patients elicited diminished release of T-cellular (e.g., IFN-gamma, IL-2) and innate immune cell-derived (e.g., CXCL9, CXCL10) cytokines in response to A. fumigatus and R. arrhizus antigens. Additionally, samples from COVID-19 patients showed deficient granulocyte activation by mold antigens and reduced fungal killing capacity of neutrophils. These features of weakened anti-mold immune responses were largely decoupled from COVID-19 severity, the time elapsed since diagnosis of COVID-19, and recent corticosteroid uptake, suggesting that impaired anti-mold defense is a common denominator of the underlying SARS-CoV-2 infection. Taken together, these results expand our understanding of the immune predisposition to post-viral mold infections and could inform future studies of immunotherapeutic strategies to prevent and treat fungal superinfections in COVID-19 patients.


PubMed ID: 36052094

Projects: A1, A2, C3, INF, Z2

Publication type: Journal

Journal: Front Immunol

Citation: Front Immunol. 2022 Aug 16;13:954985. doi: 10.3389/fimmu.2022.954985. eCollection 2022.

Date Published: 2nd Sep 2022

Registered Mode: by PubMed ID

Authors: B. Tappe, C. D. Lauruschkat, L. Strobel, J. Pantaleon Garcia, O. Kurzai, S. Rebhan, S. Kraus, E. Pfeuffer-Jovic, L. Bussemer, L. Possler, M. Held, K. Hunniger, O. Kniemeyer, S. Schauble, A. A. Brakhage, G. Panagiotou, P. L. White, H. Einsele, J. Loffler, S. Wurster

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Created: 19th Jan 2024 at 12:19

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