• Marius Trøseid, Tuva B Dahl, Jan C Holter, Anders B Kildal, Sarah L Murphy, Kuan Yang, Ana Quiles-Jiménez, Lars Heggelund, Karl Erik Müller, Anders Tveita, Annika E Michelsen, Simen Bøe, Aleksander R Holten, Hedda Hoel, Alexander Mathiessen, Trond M Aaløkken, Børre Fevang, Beathe K Granerud, Kristian Tonby, Katerina N Henriksen, Tøri V Lerum, Fredrik Müller, Ole H Skjønsberg, Andreas Barratt-Due, Anne M Dyrhol-Riise, Pål Aukrust, Bente Halvorsen, Thor Ueland, NOR-SOLIDARITY Consortium, and Norwegian SARS-CoV-2 study group.
• Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
• J. Intern. Med. 2022 Nov 1; 292 (5): 816828816-828.

BackgroundT-cell activation is associated with an adverse outcome in COVID-19, but whether T-cell activation and exhaustion relate to persistent respiratory dysfunction and death is unknown.ObjectivesTo investigate whether T-cell activation and exhaustion persist and are associated with prolonged respiratory dysfunction and death after hospitalization for COVID-19.MethodsPlasma and serum from two Norwegian cohorts of hospitalized patients with COVID-19 (n = 414) were analyzed for soluble (s) markers of T-cell activation (sCD25) and exhaustion (sTim-3) during hospitalization and follow-up.ResultsBoth markers were strongly associated with acute respiratory failure, but only sTim-3 was independently associated with 60-day mortality. Levels of sTim-3 remained elevated 3 and 12 months after hospitalization and were associated with pulmonary radiological pathology after 3 months.ConclusionOur findings suggest prolonged T-cell exhaustion is an important immunological sequela, potentially related to long-term outcomes after severe COVID-19.© 2022 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

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