The DOI matches its Crossref record; 77 of the 77 references it cites were found in a registry or an index.
Antigen-Specific Adaptive Immunity to SARS-CoV-2 in Acute COVID-19 and Associations with Age and Disease Severity
Open accessAbstract
Limited knowledge is available on the relationship between antigen-specific immune responses and COVID-19 disease severity. We completed a combined examination of all three branches of adaptive immunity at the level of SARS-CoV-2-specific CD4 + and CD8 + T cell and neutralizing antibody responses in acute and convalescent subjects. SARS-CoV-2-specific CD4 + and CD8 + T cells were each associated with milder disease. Coordinated SARS-CoV-2-specific adaptive immune responses were associated with milder disease, suggesting roles for both CD4 + and CD8 + T cells in protective immunity in COVID-19. Notably, coordination of SARS-CoV-2 antigen-specific responses was disrupted in individuals ≥ 65 years old. Scarcity of naive T cells was also associated with aging and poor disease outcomes. A parsimonious explanation is that coordinated CD4 + T cell, CD8 + T cell, and antibody responses are protective, but uncoordinated responses frequently fail to control disease, with a connection between aging and impaired adaptive immune responses to SARS-CoV-2.
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In the citing paper
“suggesting a link between individual patient predisposition with respect to age and comorbidity [127, 128].”
From Guidelines for the use of flow cytometry and cell sorting in immunological studies (third edition) (2021) · cites this paper as [128]
In the citing paper
“there is some evidence linking robust T cell responses to mild disease outcome31.”
From Prospects for durable immune control of SARS-CoV-2 and prevention of reinfection (2021) · cites this paper as [31]
In the citing paper
“Several lines of evidence suggest that CD4+ and CD8+ T cell responses play important roles in the resolution of SARS-CoV-2 infection and COVID-19,33 including modulating disease severity in humans34,35 and reducing viral loads in non-human primates.36”
From Impact of SARS-CoV-2 variants on the total CD4+ and CD8+ T cell reactivity in infected or vaccinated individuals (2021) · cites this paper as [34]
In the citing paper
“Studies of acute and convalescent COVID-19 patients have observed that SARS-CoV-2-specific T cell responses are significantly associated with milder disease (Liao et al., 2020; Rydyznski Moderbacher et al., 2020; Sekine et al., 2020; Zhou et al., 2020b), suggesting that T cell responses may be important for control and resolution of a primary SARS-CoV-2 infection.”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“In contrast, the strikingly extended absence of SARS-CoV-2-specific CD4+ T cells was associated with severe or fatal COVID-19 (>day 22 PSO in some cases) (Braun et al., 2020; Rydyznski Moderbacher et al., 2020; Tan et al., 2020a).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“Notably, SARS-CoV-2-specific CD4+ T cells had the strongest association with lessened COVID-19 disease severity, compared with antibodies and CD8+ T cells (Rydyznski Moderbacher et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“In contrast, IL-22, which can also be made by mucosal CD4+ T cells, appears to be robustly expressed by SARS-CoV-2-specific CD4+ T cells (Grifoni et al., 2020; Rydyznski Moderbacher et al., 2020; Weiskopf et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“T cell responses are detected after almost all SARS-CoV-2 infections (Grifoni et al., 2020; Rydyznski Moderbacher et al., 2020; Peng et al., 2020; Sekine et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“CD4+ T cell responses to SARS-CoV-2 are more prominent than CD8+ T cell responses (Grifoni et al., 2020; Sekine et al., 2020) and have been associated with control of primary SARS-CoV-2 infection (Rydyznski Moderbacher et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“Overall, circulating SARS-CoV-2-specific CD8+ T cells are less consistently observed than CD4+ T cells (Grifoni et al., 2020; Rydyznski Moderbacher et al., 2020; Sekine et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“Although neutralizing antibody titers have not correlated with reduced COVID-19 severity (Dan et al., 2021; Piccoli et al., 2020; Robbiani et al., 2020), SARS-CoV-2 cTfh cell frequencies have been associated with reduced disease severity (Rydyznski Moderbacher et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“In SARS-CoV-2 infections, the presence of virus-specific CD8+ T cells has been associated with better COVID-19 outcomes (Rydyznski Moderbacher et al., 2020; Peng et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“The dominant cytokine produced by SARS-CoV-2-specific CD4+ T cells from COVID-19 patients is IFNγ (Braun et al., 2020; Grifoni et al., 2020; Rydyznski Moderbacher et al., 2020; Weiskopf et al., 2020), with a clear IFNγ, tumor necrosis factor (TNF), IL-2 protein signature of canonical Th1 cells (Braun et al., 2020; Rydyznski Moderbacher et al., 2020; Peng et al., 2020; Sekine et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“SARS-CoV-2-specific CD4+ T cells can be detected as early as days 2–4 post-symptom onset (PSO) (Rydyznski Moderbacher et al., 2020; Tan et al., 2020a; Weiskopf et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“The vast majority of SARS-CoV-2 infected individuals seroconvert within 5–15 days PSO, with ∼90% seroconversion by day 10 PSO (Long et al., 2020; Rydyznski Moderbacher et al., 2020; Premkumar et al., 2020; Ripperger et al., 2020; Suthar et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“Last, there were initially great concerns about potential immune deviation to Th2 and immunopathogenesis (Peeples, 2020), but SARS-CoV-2-specific CD4+ T cells from patients consistently do not have Th2 characteristics (Grifoni et al., 2020; Rydyznski Moderbacher et al., 2020; Sekine et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“Separately, there are multiple reports of healthy individuals successfully controlling a SARS-CoV-2 infection with little to no neutralizing (or RBD IgG) antibodies detectable post-infection, while having significant SARS-CoV-2-specific T cell memory (Rydyznski Moderbacher et al., 2020; Nelde et al., 2021; Schulien et al., 2020; Sekine et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“There is an ∼1,000-fold range in the magnitude of antibody responses to SARS-CoV-2, as well as heterogeneity in the magnitude of SARS-CoV-2-specific CD4+ T cell and CD8+ T cell responses (Grifoni et al., 2020; Rydyznski Moderbacher et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“data indicate that T cell responses are important for prevention of severe COVID-19 (Rydyznski Moderbacher et al., 2020)”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“Older individuals are less likely to make a coordinated adaptive immune response to SARS-CoV-2 (Rydyznski Moderbacher et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“COVID-19 disease severity was inversely correlated with the frequency of naive T cells (Mathew et al., 2020; Rydyznski Moderbacher et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“it appears that one component of the risk is poor T cell responses due in part to a more limited naive T cell repertoire”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“the findings that Spike is a good target for CD4+ T cell responses, Tfh cell responses, and CD8+ T cell responses in SARS-CoV-2-infected people”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Rydyznski Moderbacher et al., 2020
In the citing paper
“Current evidence suggests an early, robust, and diverse T cell response directed against SARS-CoV-2 correlates with milder COVID-19 outcomes126,131,132”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“Adaptive responses to SARS-CoV-2 begin around one week after symptoms (Figure 2), with SARS-CoV-2 specific CD4+ and CD8+ T cells being observed as early as four days post-symptom onset126.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“SARS-CoV-2 infection elicits a Th1 CD4+ T cell response, with IFNγ and IL-2 being the primary cytokines produced by these cells and some TNFα production as well112,126-129.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“Low frequencies of naive T cells have also been correlated with severe COVID-19 outcomes126.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“For CD8+ T cells, there are reports of diminished CD8+ cytotoxicity and cytokine production in severe cases126,132, while others report the opposite141, and still others find no differences142.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“Consistent with this hypothesis, one study identified the presence of IFNγ producing CD8+ T cells during the acute stages of disease as the strongest predictor of mild COVID-19 outcomes126.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“Many studies have reported a correlation between higher IgG antibody titers and severe disease, but others have seen either the opposite or no correlation between antibody production and disease severity126.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“This response occurs concurrently with the detection of circulating SARS-CoV-2 specific T Follicular Helper cells, suggesting a role for T-dependent antibody production126.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“Many studies have reported a correlation between higher IgG antibody titers and severe disease, but others have seen either the opposite or no correlation between antibody production and disease severity126.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [126]
In the citing paper
“In COVID-19 patients, a coordinated adaptive immunity of CD4+ T cells, CD8+ T cells, and antibody responses was correlated to milder disease, whereas an uncoordinated response frequently failed to control disease [68]”
From The dawn of mRNA vaccines: the COVID-19 case (2021) · cites this paper as [68]
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BackgroundHighly functional virus-specific cellular immune response in asymptomatic SARS-CoV-2 infection
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Self-citationThe germinal centre B cell response to SARS-CoV-2
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“This immune response fights intracellular infections, including viruses (38), some bacteria, fungi (39), and protozoans (40).”
BackgroundBNT162b2 vaccination induces durable SARS-CoV-2–specific T cells with a stem cell memory phenotype
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Adjuvants for Coronavirus Vaccines
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“While mechanistic studies are still being conducted, emerging evidence has suggested that SRAS-CoV-2-specific CD4 and CD8 T cells in coordination with neutralizing antibodies are required for generating protective immunity against SARS-CoV-2 (33).”
BackgroundResultInfluentialLeukocyte trafficking to the lungs and beyond: lessons from influenza for COVID-19
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“SARSCoV-2-specific CD8 T-cell responses correlate with low disease severity during the acute phase [104].”
BackgroundAge-associated remodeling of T cell immunity and metabolism
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The Impact of Evolving SARS-CoV-2 Mutations and Variants on COVID-19 Vaccines
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T Cell Responses to SARS-CoV-2
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“61; Supplemental Figure 2A), as previously reported (8, 15, 42, 43).”
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Self-citationHyperinflammatory Immune Response and COVID-19: A Double Edged Sword
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“Detected as early as 2 to 4 days after onset of COVID-19 symptoms (33), CD4+ T cells play an important role in assisting the development of CD8+ cells and B cells.”
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Background
Metadata
- Authors
- Rydyznski Moderbacher, C., Ramirez, S. I., Dan, J. M., Grifoni, A., Hastie, K. M., Weiskopf, D., Belanger, S., Abbott, R. K., Kim, C., Choi, J., Kato, Y., Crotty, E. G., Kim, C., Rawlings, S. A., Mateus, J., Tse, L. P. V., Frazier, A., Baric, R., Peters, B., Greenbaum, J., Saphire, E. O., Smith, D. M., Sette, A., & Crotty, S.
- Affiliations
- La Jolla Institute for Immunology (US)
- University of California San Diego (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Sette, Alessandro
- Crotty, Shane
- ORCID
- Ramirez, Sydney I.
- Dan, Jennifer M.
- Grifoni, Alba
- Hastie, Kathryn M.
- Weiskopf, Daniela
- Abbott, Robert K.
- Kim, Christina
- Choi, Jinyong
- Kato, Yu
- Kim, Cheryl
- Rawlings, Stephen A.
- Mateus, Jose
- Tse, Long Ping Victor
- Frazier, April
- Baric, Ralph
- Peters, Bjoern
- Greenbaum, Jason
- Saphire, Erica Ollmann
- Smith, Davey M.
- Sette, Alessandro
- Crotty, Shane
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 183
- Issue
- 4
- Pages
- 996-1012.e19
- ISSN
- 0092-8674 (ISSN-L)
- PMC
- PMC7494270
- OpenAlex
- W3084879098
- Cited by
- 1,790
- References
- 77
- Citations by year
- 2026: 54 · 2025: 144 · 2024: 180 · 2023: 288 · 2022: 543 · 2021: 517 · 2020: 62
- FWCI
- 46.45
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Cell (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Bill and Melinda Gates Foundation (INV-006133)
- National Institute of Allergy and Infectious Diseases (U19 AI118626, AI100625, 75N9301900065, AI142742, AI145762, AI135078)
- National Institutes of Health
- Pontificia Universidad Javeriana
- University of California, San Diego
- Departamento Administrativo de Ciencia, Tecnología e Innovación
- Wellcome
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Keywords
- SARS-CoV-2, COVID-19 pandemic, CD4+ T cells, CD8+ T cells, neutralizing antibodies, disease severity, age, naive T cells, immunosenescence
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Acute Disease, Adult, Aged, Aged, 80 and over, Antibodies, Viral, Antigens, Viral, Female, Humans, Male, Middle Aged, Pneumonia, Viral, Severity of Illness Index, CD4-Positive T-Lymphocytes, Cytokines, Coronavirus Infections, CD8-Positive T-Lymphocytes, Young Adult, Adaptive Immunity, Antibodies, Neutralizing, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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