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T cell response to SARS-CoV-2 infection in humans: a systematic review

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Title: T cell response to SARS-CoV-2 infection in humans: a systematic review
Authors: Shrotri, M
Van Schalkwyk, MCI
Post, N
Eddy, D
Huntley, C
Leeman, D
Rigby, S
Williams, SV
Bermingham, W
Kellam, P
Maher, J
Shields, AM
Amirthalingam, G
Peacock, SJ
Ismail, S
Item Type: Journal Article
Abstract: Background Understanding the T cell 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. 55 (90%) studies used observational designs, 50 (82%) involved hospitalised patients with higher acuity illness, 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. Conclusion 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, as well as a striking lack of research in asymptomatic or pauci-symptomatic individuals. In contrast to antibody responses, population-level surveillance of the T cell response is unlikely to be feasible in the near term. Focused evaluation in specific sub-groups, including vaccine recipients, should be prioritised.
Issue Date: 25-Jan-2021
Date of Acceptance: 2-Jan-2021
URI: http://hdl.handle.net/10044/1/85565
DOI: 10.1371/journal.pone.0245532
ISSN: 1932-6203
Publisher: Public Library of Science (PLoS)
Start Page: 1
End Page: 21
Journal / Book Title: PLoS One
Volume: 16
Issue: 1
Copyright Statement: © 2021 Shrotri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 215654/Z/19/Z
Keywords: COVID-19
Host-Pathogen Interactions
Immunity, Cellular
Immunity, Cellular
Host-Pathogen Interactions
General Science & Technology
Publication Status: Published
Online Publication Date: 2021-01-25
Appears in Collections:Faculty of Medicine
Imperial College London COVID-19
School of Public Health

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