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  • SARS‐CoV‐2‐associated T‐cel...
    Mohme, Malte; Schultheiß, Christoph; Piffko, Andras; Fitzek, Antonia; Paschold, Lisa; Thiele, Benjamin; Püschel, Klaus; Glatzel, Markus; Westphal, Manfred; Lamszus, Katrin; Matschke, Jakob; Binder, Mascha

    Clinical & translational immunology, 2024, Volume: 13, Issue: 2
    Journal Article

    Objectives Infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes coronavirus disease 2019 (COVID‐19). Although an acute SARS‐CoV‐2 infection mainly presents with respiratory illness, neurologic symptoms and sequelae are increasingly recognised in the long‐term treatment of COVID‐19 patients. The pathophysiology and the neuropathogenesis behind neurologic complications of COVID‐19 remain poorly understood, but mounting evidence points to endothelial dysfunction either directly caused by viral infection or indirectly by inflammatory cytokines, followed by a local immune response that may include virus‐specific T cells. However, the type and role of central nervous system‐infiltrating T cells in COVID‐19 are complex and not fully understood. Methods We analysed distinct anatomical brain regions of patients who had deceased as a result of COVID‐19‐associated pneumonia or complications thereof and performed T cell receptor Vβ repertoire sequencing. Clonotypes were analysed for SARS‐CoV‐2 association using public TCR repertoire data. Results Our descriptive study demonstrates that SARS‐CoV‐2‐associated T cells are found in almost all brain areas of patients with fatal COVID‐19 courses. The olfactory bulb, medulla and cerebellum were brain regions showing the most SARS‐CoV‐2 specific sequence patterns. Neuropathological workup demonstrated primary CD8+ T‐cell infiltration with a perivascular infiltration pattern. Conclusion Future research is needed to better define the relationship between T‐cell infiltration and neurological symptoms and its long‐term impact on patients' cognitive and mental health. In COVID‐19 patients, neurological symptoms and complications are increasingly recognised, but their underlying causes remain poorly understood. This study found that SARS‐CoV‐2‐associated T cells were present in various brain regions of patients who had fatal COVID‐19 pneumonia, with the olfactory bulb, medulla and cerebellum showing the most specific patterns. These T cells primarily consisted of CD8+ T cells and were localised around blood vessels. Further research is required to fully understand the connection between T‐cell infiltration in the brain and its impact on patients' cognitive and mental health in the long term.