A Short Corticosteroid Course Reduces Symptoms and Immunological Alterations Underlying Long-COVID



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Utrero Rico, Alberto and Ruiz Ruigómez, María and Laguna Goya, Rocío and Arrieta Ortubay, Estíbaliz and Chivite Lacaba, Marta and González Cuadrado, Cecilia and Lalueza Blanco, Antonio and Almendro Vazquez, Patricia and Serrano, Antonio and Aguado García, José María and Lumbreras Bermejo, Carlos Juan and Paz Artal, Estela (2021) A Short Corticosteroid Course Reduces Symptoms and Immunological Alterations Underlying Long-COVID. Biomedicines, 9 (11). p. 1540. ISSN 2227-9059

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Official URL: https://doi.org/10.3390/biomedicines9111540


Despite the growing number of patients with persistent symptoms after acute SARS-CoV-2 infection, the pathophysiology underlying long-COVID is not yet well characterized, and there is no established therapy. We performed a deep immune profiling in nine patients with persistent symptoms (PSP), before and after a 4-day prednisone course, and five post-COVID-19 patients without persistent symptoms (NSP). PSP showed a perturbed distribution of circulating mononuclear cell populations. Symptoms in PSP were accompanied by a pro-inflammatory phenotype characterized by increased conventional dendritic cells and augmented expression of antigen presentation, co-stimulation, migration, and activation markers in monocytes. The adaptive immunity compartment in PSP showed a Th1-predominance, decreased naïve and regulatory T cells, and augmentation of the PD-1 exhaustion marker. These immune alterations reverted after the corticosteroid treatment and were maintained during the 4-month follow-up, and their normalization correlated with clinical amelioration. The current work highlights an immunopathogenic basis together with a possible role for steroids in the treatment for long-COVID.

Item Type:Article
Uncontrolled Keywords:long-COVID; immunological alterations; corticosteroids
Subjects:Medical sciences > Medicine > Immunology
ID Code:69645
Deposited On:04 Feb 2022 08:05
Last Modified:04 Feb 2022 09:03

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