Alexander Huang, Virtual COVID-19 Symposium: March 16, 2022

Alexander Huang, MD, Assistant Professor of Medicine, Department of Medicine, Penn Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, “T cell responses in acute and persistent COVID-19”

The PD-1 blockade breaks down T-cells. After giving a dose of PD-1 blockade a burst of immune response is seen in seven days. People with severe COVID-19 have significant immune fingerprints when compared with people with mild or null COVID-19. The severe patients have elevated neutrophils and plasmablasts with robust SARS-CoV-2 specific humoral response. Increased CD 4/8 T-cells activation and lymphopenia is also seen. The T-cells contribute to adaptive immunity. Cancer patients have high COVID-19 mortality. 25.6% pooled COVID-19 case fatality rate in patients with cancer. Hematologic cancer is an independent risk factor for COVID-19 mortality. Hugh dimensional analysis reveals 5 immune phenotypes: cluster 1, cluster 2, cluster 3, cluster 4 and cluster 5. A patient’s clusters are driven by CD4, CD8 and B-cells. T-cells depleted phenotype associated with high mortality despite antibody responses. Increased CD8 activation is driven by heame cancer patients. CD8 T-cells count correlated with survival in heme cancer patients treated with alpha CD20. Survival in heme cancer patients correlated with CD8 T-cell counts. Heme cancer patients have SARS-CoV-2 specific T-cell responses.

Therefore, it is concluded that hematologic cancer patients have defective humoral immunity. CD8 T-cells are more activated and compensate for defective humoral immunity. Greater number of CD8 T-cells are associated with survival.

Видео Alexander Huang, Virtual COVID-19 Symposium: March 16, 2022 канала Herbert Irving Comprehensive Cancer Center at Columbia