Shrotri, Madhumita; van Schalkwyk, May CI; Post, Nathan; Eddy, Danielle; Huntley, Catherine; Leeman, David; Rigby, Samuel; Williams, Sarah V; Bermingham, William H; Kellam, Paul; +5 more... Maher, John; Shields, Adrian M; Amirthalingam, Gayatri; Peacock, Sharon J; Ismail, Sharif A; (2020) Cellular immune response to SARS-CoV-2 infection in humans: a systematic review. medRxiv preprint - BMJ Yale. ISSN 1468-5833 DOI: https://doi.org/10.1101/2020.08.24.20180679
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
ABSTRACT Introduction Understanding the cellular immune response to SARS-CoV-2 is critical to vaccine development, epidemiological surveillance and control strategies. This systematic review critically evaluates and synthesises the relevant peer-reviewed and pre-print literature published in recent months. Methods For this systematic review, independent keyword-structured literature searches were carried out in MEDLINE, Embase and COVID-19 Primer for studies published from 01/01/2020-26/06/2020. Papers were independently screened by two researchers, with arbitration of disagreements by a third researcher. Data were independently extracted into a pre-designed Excel template and studies critically appraised using a modified version of the MetaQAT tool, with resolution of disagreements by consensus. Findings were narratively synthesised. Results 61 articles were included. Almost all studies used observational designs, were hospital-based, and the majority had important limitations. Symptomatic adult COVID-19 cases consistently show peripheral T cell lymphopenia, which positively correlates with increased disease severity, duration of RNA positivity, and non-survival; while asymptomatic and paediatric cases display preserved counts. People with severe or critical disease generally develop more robust, virus-specific T cell responses. T cell memory and effector function has been demonstrated against multiple viral epitopes, and, cross-reactive T cell responses have been demonstrated in unexposed and uninfected adults, but the significance for protection and susceptibility, respectively, remains unclear. Interpretation A complex pattern of T cell response to SARS-CoV-2 infection has been demonstrated, but inferences regarding population level immunity are hampered by significant methodological limitations and heterogeneity between studies. In contrast to antibody responses, population-level surveillance of the cellular response is unlikely to be feasible in the near term. Focused evaluation in specific sub-groups, including vaccine recipients, should be prioritised.
Item Type | Article |
---|---|
Faculty and Department |
Faculty of Public Health and Policy > Dept of Health Services Research and Policy Faculty of Public Health and Policy > Dept of Global Health and Development |
Research Centre | Covid-19 Research |
Elements ID | 154050 |
Copyright Holders | The Authors |
Download
Restricted to: Repository staff only
Filename: 2020.08.24.20180679v1.full(1).pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0