Immunocompromised pediatric patients showed T-cell activity and humoral immunity against SARS-CoV-2

According to data from a cohort of adult and pediatric patients with antibody deficiencies, patients who often lacked a protective immune response to infections and vaccinations showed robust T cell activity and humoral immunity to SARS-CoV-2 structural proteins. The new study, led by researchers at Children’s National Hospital, is the first to demonstrate a robust T cell response against SARS-CoV-2 in immunocompromised patients.

“If T cell responses to SARS-CoV-2 are indeed protective, then this could suggest that adoptive T cell immunotherapy could benefit deeper immunocompromised patients,” said Michael Keller, MD, director of the Translational Research Laboratory. the Cell Improvement and Immunotherapy Technologies (CETI) Program at Children’s National. “Through our developing phase I T cell immunotherapy protocol, we intend to investigate whether coronavirus-specific T cells can be protective after bone marrow transplantation, as well as in other immunodeficient populations.”

The study, published in the Journal of Clinical Immunology, found that patients with antibody deficiency disorders, including congenital immunity errors (IEI) and common variable immunodeficiency (CVID), can build an immune response to SARS-CoV-2. The findings suggest that vaccination may still be useful for this population.

“These data suggest that many antibody deficient patients should be able to respond to COVID-19 vaccines, and current studies at the National Institutes of Health and elsewhere are examining whether those responses are likely to be protective and lasting,” said Dr. Keller. The T cell responses in all COVID-19 patients were comparable in magnitude to healthy adult and pediatric convalescent participants.

Kinoshita et al. Call for additional studies to further define the quality of the antibody response and the longevity of immune responses against SARS-CoV-2 in immunocompromised patients compared to healthy donors. Currently, there is also very little data on adaptive immune responses to SARS-CoV-2 in these vulnerable populations.

The study sheds light on the antibody and T cell responses to SARS-CoV-2 protein peaks based on a sample size of six patients, including a family group of three children and their mother. All are deficient in antibodies and developed mild COVID-19 symptoms, minus one child who remained asymptomatic. The control participants were the father of the same family, who tested positive for COVID-19, and another occasional adult (no close relative) experienced mild COVID-19 symptoms. The researchers took blood samples to test the T cell response in cell cultures and provided a comprehensive statistical analysis of the adaptive immune responses.

“This was a small group of patients, but given the high response rate, it suggests that many of our antibody-deficient patients are likely to build up immune responses to SARS-CoV-2,” said Dr. Keller. “Additional studies are needed to know if other patients with primary immunodeficiency develop immunity after COVID-19 infection and are likely to be answered by a large international collaboration organized by our staff at the Garvan Institute in Sydney.”


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