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Front Immunol . Markers of T cell activation and exhaustion in plasma are associated with persistent symptoms up to 18 months following mild SARS-Co

tetano

Editor, Senior Moderator
Front Immunol


. 2025 May 30:16:1578208.
doi: 10.3389/fimmu.2025.1578208. eCollection 2025. Markers of T cell activation and exhaustion in plasma are associated with persistent symptoms up to 18 months following mild SARS-CoV-2 infection

Thor Ueland[SUP] 1 2 3 [/SUP], Rebecca Jane Cox[SUP] 4 5 6 [/SUP], Annika E Michelsen[SUP] 1 2 [/SUP], Elisabeth Berg Fjelltveit[SUP] 4 5 [/SUP], Kari Otterdal[SUP] 1 [/SUP], Tuva Dahl[SUP] 1 [/SUP], Fan Zhou[SUP] 5 [/SUP], Rebecca Elyanow[SUP] 7 [/SUP], Pål Aukrust[SUP] 1 2 8 [/SUP], Bjørn Blomberg[SUP] 6 9 [/SUP], Bente E Halvorsen[SUP] 1 2 [/SUP], Nina Langeland[SUP] 6 9 [/SUP]



Affiliations
Abstract

Background: Persistent symptoms following SARS-CoV-2 is an increasing problem after COVID-19 disease. The pathogenesis of this persistent post Covid-19 Condition (PCC) is, however, largely unknown. We hypothesized that persistent T cell activation and exhaustion play a role in PCC development.
Methods: We examined plasma levels of soluble (s) CD25, TIM-3 and LAG-3, all markers of T cell activation/exhaustion, by enzyme immunoassays in 170 home-isolated and 53 hospitalized patients for up to 18 months after COVID-19 in relation to persistent symptomatology.
Results: Our major findings were: (i) Cases with persistent dyspnea and fatigue had markedly higher sCD25 at 6-18 months with a more modest increase in sTIM-3. (ii) Cases with memory problems at 12-18 months had increased sLAG-3 iii) sCD25 correlated with SARS-CoV-2 antibody titers and microneutralization titers only in cases with PCC while sTIM-3 correlated with these parameters irrespectively of symptoms. iv) Although hospitalized patients had markedly elevated levels of T cell activation/exhausting markers during follow-up, there was no relation to PCC symptoms.
Conclusion: Our study indicates a role for T cell activation/exhaustion in PCC following home isolated COVID-19 infection, with somewhat different patterns of sCD25, sTIM-3 and sLAG-3, but not in hospitalized COVID-19 patients where disease severity may be more important.

Keywords: SARS-CoV-2; T cell activation and exhaustion; long-term follow-up; mild covid-19 infection; persistent symptoms; post-covid condition.

 
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