Alterations in T and B cell function persist in convalescent COVID-19 patients

Halima A. Shuwa, Tovah N. Shaw, Sean B. Knight, Kelly Wemyss, Flora A. McClure, Laurence Pearmain, Ian Prise, Christopher Jagger, David J Morgan, Saba Khan, Oliver Brand, Elizabeth R. Mann, Andrew Ustianowski, Nawar Diar Bakerly, Paul Dark, Christopher E. Brightling, Seema Brij, Timothy Felton, Angela Simpson, John R. GraingerTracy Hussell, Joanne E. Konkel, Madhvi Menon

Research output: Contribution to journalArticlepeer-review


Emerging studies indicate that some COVID-19 patients suffer from persistent symptoms including breathlessness and chronic fatigue; however the long-term immune response in these patients presently remains ill-defined.

Here we describe the phenotypic and functional characteristics of B and T cells in hospitalised COVID-19 patients during acute disease and at 3-6 months of convalescence.

We report that the alterations in B cell subsets observed in acute COVID-19 patients were largely recovered in convalescent patients. In contrast, T cells from convalescent patients displayed continued alterations with persistence of a cytotoxic programme evident in CD8+ T cells as well as elevated production of type-1 cytokines and IL-17. Interestingly, B cells from patients with acute COVID-19 displayed an IL-6/IL-10 cytokine imbalance in response to toll-like receptor activation, skewed towards a pro-inflammatory phenotype. Whereas the frequency of IL-6+ B cells was restored in convalescent patients irrespective of clinical outcome, recovery of IL-10+ B cells was associated with resolution of lung pathology.

Our data detail lymphocyte alterations in previously hospitalized COVID-19 patients up to 6 months following hospital discharge and identify 3 subgroups of convalescent patients based on distinct lymphocyte phenotypes, with one subgroup associated with poorer clinical outcome. We propose that alterations in B and T cell function following hospitalisation with COVID-19 could impact longer term immunity and contribute to some persistent symptoms observed in convalescent COVID-19 patients.
Original languageEnglish
Pages (from-to)720-735.E4
Number of pages16
Issue number6
Early online date31 Mar 2021
Publication statusPublished - 11 Jun 2021


  • COVID-19
  • T cells
  • B cells
  • long COVID
  • viral infection
  • convalescent patients


Dive into the research topics of 'Alterations in T and B cell function persist in convalescent COVID-19 patients'. Together they form a unique fingerprint.

Cite this