12 months follow-up of early phase Covid-19 patients with immune disorders and of members of their family. Cellular and humoral evolution

Aims: Evaluate the lasting immune protection and effects after SARSCoV- 2 infections in healthy individuals and in patients with immune disease Methods: 54 convalescent COVID patients from the 1st wave epidemic and 12 COVID negative close relatives accepted to participate. 29% had an auto-immune disease, 31% allergies and 13% had immune deficiencies Clinical evolution and blood samples were collected monthly for ≥ 12 months. Inflammatory markers and β2microglobulin [β2m] were measured by nephelometry, specific ab anti Spike1 were assayed by immunochromatography and ELISA, neutralizing ab by inhibition ELISA lymphocyte phenotyping by flow cytometry. Lasting memory T CD4+ and T CD8+ and mB CD19+ were determined after in vitro culture with SARS-CoV-2 recombinant proteins or self-designed peptides Results: Along the 12 months of the study, 95% of patients maintained significant antibodies and effective % of neutralising ab (peak: 3rd to 5th month). The persistence of this immunity was corroborated by the presence of circulating memory T CD4+, CD8+ and B CD19+ (month 10 and 12 post COVID). Inflammatory markers returned to pre-infection values within two months after recovery. Elevated β2m, reflecting CD8+ and CD5616+ activation, was observed only during the first month after onset In 12 patients it was again present upon reactivation during the 2nd wave. A decreased or low CD4/CD8 ratio was observed in all for more than 8 months before slowly returning to initial reference Assertion: SARS-CoV-2 immunity and pro-inflammatory profile persist much longer than postulated.