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Host-microbe multiomic profiling identifies distinct COVID-19 immune dysregulation in solid organ transplant recipients
- Pickering, Harry;
- Schaenman, Joanna;
- Phan, Hoang Van;
- Maguire, Cole;
- Tsitsiklis, Alexandra;
- Rouphael, Nadine;
- Higuita, Nelson Iván Agudelo;
- Atkinson, Mark A;
- Brakenridge, Scott;
- Fung, Monica;
- Messer, William;
- Salehi-rad, Ramin;
- Altman, Matthew C;
- Becker, Patrice M;
- Bosinger, Steven E;
- Eckalbar, Walter;
- Hoch, Annmarie;
- Doni Jayavelu, Naresh;
- Kim-Schulze, Seunghee;
- Jenkins, Meagan;
- Kleinstein, Steven H;
- Krammer, Florian;
- Maecker, Holden T;
- Ozonoff, Al;
- Diray-Arce, Joann;
- Shaw, Albert;
- Baden, Lindsey;
- Levy, Ofer;
- Reed, Elaine F;
- Langelier, Charles R
Published Web Location
https://doi.org/10.1038/s41467-025-55823-zAbstract
Coronavirus disease 2019 (COVID-19) poses significant risks for solid organ transplant recipients, who have atypical but poorly characterized immune responses to infection. We aim to understand the host immunologic and microbial features of COVID-19 in transplant recipients by leveraging a prospective multicenter cohort of 86 transplant recipients age- and sex-matched with 172 non-transplant controls. We find that transplant recipients have higher nasal SARS-CoV-2 viral abundance and impaired viral clearance, and lower anti-spike IgG levels. In addition, transplant recipients exhibit decreased plasmablasts and transitional B cells, and increased senescent T cells. Blood and nasal transcriptional profiling demonstrate unexpected upregulation of innate immune signaling pathways and increased levels of several proinflammatory serum chemokines. Severe disease in transplant recipients, however, is characterized by a less robust induction of pro-inflammatory genes and chemokines. Together, our study reveals distinct immune features and altered viral dynamics in solid organ transplant recipients.
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