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T cell phenotypes in COVID-19 - a living review

Hanna, Stephanie J., Codd, Amy S., Gea-Mallorqui, Ester, Scourfield, D. Oliver, Richter, Felix C., Ladell, Kristin ORCID:, Borsa, Mariana, Compeer, Ewoud B., Moon, Owen R., Galloway, Sarah A.E., Dimonte, Sandra, Capitani, Lorenzo, Shepherd, Freya R., Wilson, Joseph D., Uhl, Lion F. K., Ahern, David J., Almuttaqi, Hannah, Alonzi, Dominic S., Alrubayyi, Aljawharah, Alsaleh, Ghada, Bart, Valentina M. T., Batchelor, Vicky, Bayliss, Rebecca, Berthold, Dorothée L., Bezbradica, Jelena S., Bharuchq, Tehmina, Borrmann, Helene, Borsa, Mariana, Borst, Rowie, Brun, Juliane, Burnell, Stephanie, Capitani, Lorenzo, Cavounidis, Athena, Chapman, Lucy, Chauveau, Anne, Cifuentes, Liliana, Codd, Amy Susan, Compeer, Ewoud Bernardus, Coveney, Clarissa, Cross, Amy, Danielli, Sara, Davies, Luke C., Dendrou, Calliope A., Dimonte, Sandra, Peter Durairaj, Ruban Rex, Dustin, Lynn B., Dyer, Arthur, Fielding, Ceri, Fischer, Fabian, Gallimore, Awen ORCID:, Galloway, Sarah, Gammage, Anís, Gea-Mallorquí, Ester, Godkin, Andrew, Hanna, Stephanie J., Heuberger, Cornelia, Hulin-Curtis, Sarah, Issa, Fadi, Jones, Emma, Jones, Ruth, Ladell, Kristin, Lauder, Sarah N., Liddiard, Kate, Ligoxygakis, Petros, Lu, Fangfang, MacLachlan, Bruce, Maleki-Toyserkani, Shayda, Mann, Elizabeth H., Marzeda, Anna M., Matthews, Reginald James, Mazet, Julie M., Milicic, Anita, Mitchell, Emma, Moon, Owen, Nguyen, Van Dien, O'Hanlon, Miriam, Eléonore Pavillet, Clara, Peppa, Dimitra, Pires, Ana, Pring, Eleanor, Quastel, Max, Reed, Sophie, Rehwinkel, Jan, Richmond, Niamh, Richter, Felix Clemens, Robinson, Alice J. B., Rodrigues, Patrícia R. S., Sabberwal, Pragati, Sami, Arvind, Peres, Raphael Sanches, Sattentau, Quentin, Schonfeldova, Barbora, Scourfield, David Oliver, Selvakumar, Tharini A., Shepherd, Freya R., Shorten, Cariad, Simon, Anna Katharina, Smith, Adrian L., Crespo, Alicia Teijeira, Tellier, Michael, Thornton, Emily, Uhl, Lion F. K., van Grinsven, Erinke, Wann, Angus K. T., Williams, Richard, Wilson, Joseph D., Zhou, Dingxi, Zhu, Zihan, Gallimore, Awen M. and Milicic, Anita 2021. T cell phenotypes in COVID-19 - a living review. Oxford Open Immunology 2 (1) 10.1093/oxfimm/iqaa007

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COVID-19 is characterized by profound lymphopenia in the peripheral blood, and the remaining T cells display altered phenotypes, characterized by a spectrum of activation and exhaustion. However, antigen-specific T cell responses are emerging as a crucial mechanism for both clearance of the virus and as the most likely route to long-lasting immune memory that would protect against re-infection. Therefore, T cell responses are also of considerable interest in vaccine development. Furthermore, persistent alterations in T cell subset composition and function post-infection have important implications for patients’ long-term immune function. In this review, we examine T cell phenotypes, including those of innate T cells, in both peripheral blood and lungs, and consider how key markers of activation and exhaustion correlate with, and may be able to predict, disease severity. We focus on SARS-CoV-2-specific T cells to elucidate markers that may indicate formation of antigen-specific T cell memory. We also examine peripheral T cell phenotypes in recovery and the likelihood of long-lasting immune disruption. Finally, we discuss T cell phenotypes in the lung as important drivers of both virus clearance and tissue damage. As our knowledge of the adaptive immune response to COVID-19 rapidly evolves, it has become clear that while some areas of the T cell response have been investigated in some detail, others, such as the T cell response in children remain largely unexplored. Therefore, this review will also highlight areas where T cell phenotypes require urgent characterisation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Additional Information: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
ISSN: 2633-6960
Date of First Compliant Deposit: 13 September 2021
Date of Acceptance: 16 December 2020
Last Modified: 11 Oct 2023 18:52

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