Evidence map›Paper›PMID 40183283›Full record

ArticleJournal of medical virology2025

Myeloid-Driven Immune Suppression Subverts Neutralizing Antibodies and T Cell Immunity in Severe COVID-19.

Cong Lai, Su Lu, Yilin Yang, Xiaoyu You, Feixiang Xu, Xinran Deng, Lulu Lan, Yuesheng Guo, Zhongshu Kuang, Yue Luo and 5 more

Abstract read
In one paragraph

Article in Journal of medical virology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Cong LaiDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.ORCID 0009-0002-2385-5661
Su LuDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Yilin YangDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Xiaoyu YouDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Feixiang XuDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Xinran DengDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Lulu LanDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Yuesheng GuoDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Zhongshu KuangDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Yue LuoDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Li YuanDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Lu MengDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Xueling WuDepartment of Respiratory Medicine, Shanghai Jiaotong University School of Medicine, Renji Hospital, Shanghai, China.ORCID 0000-0001-8960-0181
Zhenju SongDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
Ning JiangDepartment of Emergency Medicine, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.

Funding

This work was supported by the National Key Research and Development Program of China (2021YFC2501800, 2022YFA0806200, 2023YFC0872500, and 2024YFC3044600), the National Natural Science Foundation of China (82072214, 82272198, and 82202373), the Science and Technology of Shanghai Committee (21MC1930400, 22Y11900100, and 23Y31900100), and the Shanghai Municipal Health Commission (2023ZDFC0101).
6 · The paper itself

Abstract

The objective of this study was to better understand immune failure mechanisms during severe acute respiratory syndrome coronavirus 2, SARS-CoV-2 infection, which are critical for developing targeted vaccines and effective treatments. We collected 34 cases representing different disease severities and performed high-quality single-cell TCR/BCR sequencing to analyze the peripheral immune cell profiles. Additionally, we assessed antibody-neutralizing activity through in vitro experiments. Our integrated multiomics analysis uncovers a profound immune paradox in severe COVID-19: hyperinflammation coexists with immunosuppression, driven by distinct yet interconnected dysregulatory mechanisms. Severe patients develop robust humoral immunity, evidenced by clonally expanded plasma cells producing neutralizing antibodies (e.g., IGHG1-dominated responses) and antigen-specific T cell activation. However, these protective responses are counteracted by myeloid-driven immunosuppression, particularly CD14+ HMGB2+ monocytes exhibiting metabolic reprogramming and HLA-DR downregulation, coupled with progressive T cell exhaustion characterized by IFN-γ/TNF-α hyperactivation and impaired antigen presentation. Importantly, prolonged viral persistence in severe cases arises from a failure to coordinate humoral and cellular immunity-antibody-mediated neutralization cannot compensate for defective cytotoxic T cell function and monocyte-mediated immune suppression. These findings highlight the necessity for therapeutic strategies that simultaneously enhance antibody effector functions (e.g., Fc optimization), restore exhausted T cells, and reverse myeloid suppression. They also highlight the importance of vaccines designed to elicit balanced B cell memory and durable T cell responses, which are critical to preventing severe disease progression. By addressing the dual challenges of hyperinflammation and immunosuppression, such approaches could restore immune coordination and improve outcomes in severe COVID-19.

Indexed as

Antibodies, NeutralizingAntibodies, ViralCOVID-19Immune ToleranceMyeloid CellsSARS-CoV-2T-LymphocytesAdultAgedFemaleHumansImmunity, CellularImmunity, HumoralMaleMiddle AgedAntibodies, NeutralizingAntibodies, ViralBCRCOVID‐19high‐resolution single‐cell transcriptomics peripheral immune responseshumoral immune

Identifiers

PMID40183283
PMCPMC11969634

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.