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ResearchIn-Press PreviewCOVID-19Immunology Free access | 10.1172/JCI144734

Functional monocytic myeloid-derived suppressor cells increase in blood but not airways and predict COVID-19 severity

Sara Falck-Jones,1 Sindhu Vangeti,1 Meng Yu,1 Ryan Falck-Jones,3 Alberto Cagigi,1 Isabella Badolati,1 Björn Österberg,1 Maximilian Julius Lautenbach,4 Eric Ahlberg,1 Ang Lin,1 Rico Lepzien,1 Inga Szurgot,1 Klara Lenart,1 Fredrika Hellgren,1 Holden T. Maecker,5 Jörgen Sälde,6 Jan Albert,7 Niclas Johansson,8 Max Bell,9 Karin Lore,1 Anna Färnert,8 and Anna Smed-Sörensen1

1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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1Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden

2Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden

4Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Insitutet, Solna, Sweden

5Microbiology & Immunology, Stanford University School of Medicine, Stanford, United States of America

6Health Care Services Stockholm County, Stockholm, Sweden

7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

8Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

9Department of Physiology and Pharmacology, Karolinska Insitutet, Solna, Sweden

10Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Kenya

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Published January 25, 2021 - More info

J Clin Invest. https://doi.org/10.1172/JCI144734.
Copyright © 2021, American Society for Clinical Investigation
Published January 25, 2021 - Version history
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Abstract

The immunopathology of COVID-19 remains enigmatic, exhibiting immunodysregulation and T cell lymphopenia. Monocytic myeloid-derived suppressor cells (M-MDSC) are T cell suppressors that expand in inflammatory conditions, but their role in acute respiratory infections remains unclear. We studied blood and airways of COVID-19 patients across disease severity at multiple timepoints. M-MDSC frequencies were elevated in blood but not in nasopharyngeal or endotracheal aspirates of COVID-19 patients compared to controls. M-MDSCs isolated from COVID-19 patients suppressed T cell proliferation and IFNg production partly via an arginase-1 (Arg-1) dependent mechanism. Furthermore, patients showed increased Arg-1 and IL-6 plasma levels. COVID-19 patients had fewer T cells, and displayed downregulated expression of the CD3ζ chain. Ordinal regression showed that early M-MDSC frequency predicted subsequent disease severity. In conclusion, M-MDSCs expand in blood of COVID-19 patients, suppress T cells and strongly associate with disease severity, suggesting a role for M-MDSCs in the dysregulated COVID-19 immune response.

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