SARS-CoV-2 infection elucidates features of pregnancy-specific immunity

Cell Rep. 2024 Nov 26;43(11):114933. doi: 10.1016/j.celrep.2024.114933. Epub 2024 Nov 5.

Abstract

Pregnancy is a risk factor for increased severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory infections, but the mechanisms underlying this risk are poorly understood. To gain insight into the role of pregnancy in modulating immune responses at baseline and upon SARS-CoV-2 infection, we collected peripheral blood mononuclear cells and plasma from 226 women, including 152 pregnant individuals and 74 non-pregnant women. We find that SARS-CoV-2 infection is associated with altered T cell responses in pregnant women, including a clonal expansion of CD4-expressing CD8+ T cells, diminished interferon responses, and profound suppression of monocyte function. We also identify shifts in cytokine and chemokine levels in the sera of pregnant individuals, including a robust increase of interleukin-27, known to drive T cell exhaustion. Our findings reveal nuanced pregnancy-associated immune responses, which may contribute to the increased susceptibility of pregnant individuals to viral respiratory infection.

Keywords: COVID-19; CP: Immunology; SARS-CoV-2; T cells; cytokines; immune cells; immune responses; maternal immune activation; pregnancy; single-cell RNA-seq.

MeSH terms

  • Adult
  • CD4-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes* / immunology
  • COVID-19* / blood
  • COVID-19* / immunology
  • COVID-19* / virology
  • Cytokines* / blood
  • Cytokines* / metabolism
  • Female
  • Humans
  • Leukocytes, Mononuclear / immunology
  • Pregnancy
  • Pregnancy Complications, Infectious* / blood
  • Pregnancy Complications, Infectious* / immunology
  • Pregnancy Complications, Infectious* / virology
  • SARS-CoV-2* / immunology

Substances

  • Cytokines