Cell Rep.  2021  Feb  26.  pii:  S2211-1247(21)00177-7. [Epub  ahead  of  print] 108863
Elizabeth A Thompson, 
Katherine Cascino, 
Alvaro A Ordonez, 
Weiqiang Zhou, 
Ajay Vaghasia, 
Anne Hamacher-Brady, 
Nathan R Brady, 
Im-Hong Sun, 
Rulin Wang, 
Avi Z Rosenberg, 
Michael Delannoy, 
Richard Rothman, 
Katherine Fenstermacher, 
Lauren Sauer, 
Kathyrn Shaw-Saliba, 
Evan M Bloch, 
Andrew D Redd, 
Aaron A R Tobian, 
Maureen Horton, 
Kellie Smith, 
Andrew Pekosz, 
Franco R D'Alessio, 
Srinivasan Yegnasubramanian, 
Hongkai Ji, 
Andrea L Cox, 
Jonathan D Powell.
 
  It is unclear why some SARS-CoV-2 patients readily resolve infection while others develop severe disease. By interrogating metabolic programs of immune cells in severe and recovered coronavirus disease 2019 (COVID-19) patients compared with other viral infections, we identify a unique population of T cells. These T cells express increased Voltage-Dependent Anion Channel 1 (VDAC1), accompanied by gene programs and functional characteristics linked to mitochondrial dysfunction and apoptosis. The percentage of these cells increases in elderly patients and correlates with lymphopenia. Importantly, T cell apoptosis is inhibited in vitro by targeting the oligomerization of VDAC1 or blocking caspase activity. We also observe an expansion of myeloid-derived suppressor cells with unique metabolic phenotypes specific to COVID-19, and their presence distinguishes severe from mild disease. Overall, the identification of these metabolic phenotypes provides insight into the dysfunctional immune response in acutely ill COVID-19 patients and provides a means to predict and track disease severity and/or design metabolic therapeutic regimens.
Keywords:  COVID-19; MDSCs; SARS-CoV-2; T cells; apoptosis; immunology; immunometabolism; metabolism; mitochondria