PT - JOURNAL ARTICLE AU - Divij Mathew AU - Josephine R. Giles AU - Amy E. Baxter AU - Allison R. Greenplate AU - Jennifer E. Wu AU - Cécile Alanio AU - Derek A. Oldridge AU - Leticia Kuri-Cervantes AU - M. Betina Pampena AU - Kurt D’Andrea AU - Sasikanth Manne AU - Zeyu Chen AU - Yinghui Jane Huang AU - John P. Reilly AU - Ariel R Weisman AU - Caroline A.G. Ittner AU - Oliva Kuthuru AU - Jeanette Dougherty AU - Kito Nzingha AU - Nicholas Han AU - Justin Kim AU - Ajinkya Pattekar AU - Eileen C. Goodwin AU - Elizabeth M. Anderson AU - Madison E. Weirick AU - Sigrid Gouma AU - Claudia P. Arevalo AU - Marcus J. Bolton AU - Fang Chen AU - Simon F. Lacey AU - Scott E. Hensley AU - Sokratis Apostolidis AU - Alexander C. Huang AU - Laura A. Vella AU - The UPenn COVID Processing Unit AU - Michael R. Betts AU - Nuala J. Meyer AU - E. John Wherry TI - Deep immune profiling of COVID-19 patients reveals patient heterogeneity and distinct immunotypes with implications for therapeutic interventions AID - 10.1101/2020.05.20.106401 DP - 2020 Jan 01 TA - bioRxiv PG - 2020.05.20.106401 4099 - http://biorxiv.org/content/early/2020/05/23/2020.05.20.106401.short 4100 - http://biorxiv.org/content/early/2020/05/23/2020.05.20.106401.full AB - COVID-19 has become a global pandemic. Immune dysregulation has been implicated, but immune responses remain poorly understood. We analyzed 71 COVID-19 patients compared to recovered and healthy subjects using high dimensional cytometry. Integrated analysis of ∼200 immune and >30 clinical features revealed activation of T cell and B cell subsets, but only in some patients. A subgroup of patients had T cell activation characteristic of acute viral infection and plasmablast responses could reach >30% of circulating B cells. However, another subgroup had lymphocyte activation comparable to uninfected subjects. Stable versus dynamic immunological signatures were identified and linked to trajectories of disease severity change. These analyses identified three “immunotypes” associated with poor clinical trajectories versus improving health. These immunotypes may have implications for therapeutics and vaccines.Competing Interest StatementThe authors have declared no competing interest.