Multi-omic longitudinal study reveals immune correlates of clinical course among hospitalized COVID-19 patients

Published: 11 May 2023| Version 2 | DOI: 10.17632/vcskpv8tjk.2
Joann Diray-Arce


The IMPACC cohort, composed of >1,000 hospitalized COVID-19 participants, contains five illness trajectory groups (TGs) during acute infection (first 28 days), ranging from milder (TG1-3) to more severe disease course (TG4) and death (TG5). Here, we report deep immunophenotyping, profiling of >15,000 longitudinal blood and nasal samples from 540 participants of the IMPACC cohort, using 14 distinct assays. These unbiased analyses identify cellular and molecular signatures present within 72 hours of hospital admission that distinguish moderate from severe and fatal COVID-19 disease. Importantly, cellular and molecular states also distinguish participants with more severe disease that recover or stabilize within 28 days from those that progress to fatal outcomes (TG4 vs. TG5). Furthermore, our longitudinal design reveals that these biologic states display distinct temporal patterns associated with clinical outcomes. Characterizing host immune responses in relation to heterogeneity in disease course may inform clinical prognosis and opportunities for intervention.


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University of Florida, Brigham and Women's Hospital, Drexel University, Benaroya Research Institute at Virginia Mason, Icahn School of Medicine at Mount Sinai, Yale University School of Public Health, Case Western Reserve University, National Institute of Allergy and Infectious Diseases, La Jolla Institute for Allergy and Immunology, Tower Health, University of California San Francisco, Metabolon Inc, Yale University School of Medicine, Oklahoma University Medical Center, University of Texas at Austin, University Hospitals, Stanford University School of Medicine, Harvard Medical School, Oregon Health & Science University, University of Arizona, Baylor College of Medicine, University of California Los Angeles David Geffen School of Medicine, Boston Children's Hospital, Emory University School of Medicine, University of South Florida


Immunology, Infectious Disease, Bioinformatics, Systems Biology, Big Data, COVID-19