Corticosteroids have beneficial effects in improving outcomes in hospitalized patients with severe COVID-19 by suppressing excessive immune responses. However, the effect of corticosteroids on the humoral and T-cell responses of survivors of COVID-19 1 year after infection remains uncertain because it relates to the extent of immediate, antigen-specific defense provided by protective memory. What is the effect of corticosteroids on long-term humoral and T-cell immune responses? In this retrospective cohort study conducted at a single center, we analyzed data from a cohort who had survived COVID-19 to compare the 1-year seropositivity and titer changes in neutralizing antibodies (NAbs) and SARS-CoV-2-specific antibodies. Additionally, we evaluated the magnitude and rate of SARS-CoV-2-specific T-cell response in individuals who received corticosteroids during hospitalization and those who did not. Our findings indicated that corticosteroids do not statistically influence the kinetics or seropositive rate of NAbs against the Wuhan strain of SARS-CoV-2 from 6 months to 1 year. However, subgroup analysis revealed a numerical increase of absolute NAbs titers, from 20.0 to 28.2, in categories where long-term (> 15 days) and high-dose (> 560 mg) corticosteroids are administered. Similarly, corticosteroids showed no significant effect on nucleoprotein and receptor-binding domain IgG at 1 year, except for spike protein IgG (β, 0.08; 95% CI, 0.04-0.12), which demonstrated a delayed decline of titers. Regarding T-cell immunity, corticosteroids did not affect the rate or magnitude of T-cell responses significantly. However, functional assessment of memory T cells revealed higher interferon-γ responses in CD4 (β, 0.61; 95% CI, 0.10-1.12) and CD8 (β, 0.63; 95% CI, 0.11-1.15) memory T cells in the corticosteroids group at 1 year. Based on our findings, short-term and low-dose corticosteroid therapy during hospitalization does not have a significant effect on long-term humoral kinetics or the magnitude and rate of memory T-cell responses to SARS-CoV-2 antigens. However, the potential harmful effects of long-term and high-dose corticosteroid use on memory immune responses require further investigation.

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皮质类固醇对住院 COVID-19 患者随访中长期体液和记忆 T 细胞反应的影响

皮质类固醇通过抑制过度的免疫反应，对改善重症 COVID-19 住院患者的预后具有有益作用。然而，皮质类固醇对感染 1 年后 COVID-19 幸存者的体液和 T 细胞反应的影响仍不确定，因为它与保护性记忆提供的即时抗原特异性防御​​的程度有关。皮质类固醇对长期体液和 T 细胞免疫反应有何影响？在这项在单一中心进行的回顾性队列研究中，我们分析了 COVID-19 幸存者队列的数据，以比较中和抗体 (NAb) 和 SARS-CoV-2 特异性抗体的 1 年血清阳性率和滴度变化。此外，我们还评估了住院期间接受和未接受皮质类固醇治疗的个体的 SARS-CoV-2 特异性 T 细胞反应的程度和速率。我们的研究结果表明，从 6 个月到 1 年的时间里，皮质类固醇对 NAb 对抗 SARS-CoV-2 武汉株的动力学或血清阳性率没有统计学影响。然而，亚组分析显示，在长期（> 15 天）和高剂量（> 560 mg）皮质类固醇给药的类别中，NAb 绝对滴度数值增加，从 20.0 增加到 28.2。同样，皮质类固醇在 1 年时对核蛋白和受体结合域 IgG 没有显着影响，但刺突蛋白 IgG（β，0.08；95% CI，0.04-0.12）除外，表明滴度延迟下降。关于 T 细胞免疫，皮质类固醇不会显着影响 T 细胞反应的速率或幅度。然而，记忆 T 细胞的功能评估显示，皮质类固醇中 CD4（β，0.61；95% CI，0.10-1.12）和 CD8（β，0.63；95% CI，0.11-1.15）记忆 T 细胞具有较高的干扰素-γ 应答。 1年组。根据我们的研究结果，住院期间的短期和低剂量皮质类固醇治疗对长期体液动力学或记忆 T 细胞对 SARS-CoV-2 抗原反应的程度和速率没有显着影响。然而，长期大剂量使用皮质类固醇对记忆免疫反应的潜在有害影响需要进一步研究。