Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Authors:Laing et al. 

Journal/ Pre-Print:medRxiv 

Tags: Diagnostics, Immunology/Immunity 

Research Highlights

  1. Mild, moderate and severe COVID-19 patients produce anti-SARS-CoV-2 antibodies. 

  1. Changes in the proportions of subsets of B, DC, monocytes and T cells in COVID-19s patients similar to those seen in sepsis. 

  1. Elevated IP10, decrease basophils and pDC population and chronic T cell activation is correlated with disease severity. 


This study shows the first results of the COVID-ImmunoPhenotyping project (COVID-IP,London). Flow cytometry analysis of blood cells using multiparameter panels associated with cytokine and anti-SARS-CoV2 antibody detections by ELISA were performed oa cohort of 63 hospitalized COVID-19 patients and 55 healthy controls the first day of hospitalisation. 

As previously reported in other cohorts, most COVID-19 patients had SARS-CoV2 antibody response, elevated cytokines, and pan-lymphopenia. While these factors were not associated with the disease severity, the decrease in basophils and pDC, the downregulation of HLA-DR and CD86 on some monocytes and DC populations and the increased level of IP-10 were. Furthermore, in addition to the overall sepsis-like T cell subsets dysregulation and depletion, some discrete parameters such as the expression of exhaustion markers were also good indicators of the disease severity. 

This analysis revealed a particular COVID immune signature that could be adapted, in a prediction purpose, for the early screening of patients. 

Impact for SARS-CoV2/COVID19 research efforts 

Understand the immune response to SARS-CoV2/COVID19 – the results of this study imply prognostic value for immunophenotyping coronavirus patients and identifying those at risk of developing more severe disease e.g. by elevated IP10 plasma levels and T cytopenia accompanied by chronic activation phenotype associated with immune exhaustion. 

Study Type  

  • Clinical Cohort study (63 COVID-19 patients and 55 healthy control) 

Strengths and limitations of the paper 

Novelty: This study suggests that specific differences in the immune response mounted against SARS-CoV-2 may account in part for differences in disease severity between patients, identifying changes to specific immune cell subsets and a T cell exhaustion phenotype characteristic of more severe disease 

Standing in the field: Similarly to previous publication, they report the presence of anti SARS-CoV2 antibodies in most patients, T cell exhaustion phenotype and cytopenia (also reported in sepsis patients). In contrast to previous studies, they didn’t observe drastic neutrophils and NK cell number modification in their cohort.  

Appropriate statistics: Yes, and data adjusted for differences in age and sex of patients 

Viral model used:Patients with SARS-CoV-2  

Translatability: Potential to apply this blood immunophenotyping on detected COVID-19 patients to generate at early timepoint risk based patient stratification. 

Main limitations: Small cohort of 63 patients. Temporal variation in sampling as all patients sampled on day 1 i.e. day of positive qPCR test, not day of symptom onset. Not all patients were then followed up for blood tests at days 3 and 9. The differences they identify between severe and non-severe disease (e.g. T cell exhaustion phenotype, elevated IP10) will not be of prognostic value if they arise after the onset of severe symptoms.