HLA-B*15:01-positive severe COVID-19 patients lack CD8 <sup>+</sup> T cell pools with highly expanded public clonotypes

L Louise C. Rowntree (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) L Lilith F. Allen (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) R Ruth R. Hagen (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) H Hayley A. McQuilten (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) A Ahmed A. Quadeer (Department of Electronic and Computer Engineering, School of Engineering, Hong Kong University of Science and Technology, Hong Kong Special Administrative Region) P Priyanka Chaurasia (Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University) P Prathanporn Kaewpreedee (HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region) K Kelly W. K. Lee (HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region) C Carolyn A. Cohen (HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region) J Jan Petersen (Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University) D Dene R. Littler J Jennifer R. Habel (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) W Wuji Zhang (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) S Samuel M. S. Cheng (Division of Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region) K Ken Ka Pang Chan (Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong) J Janette S. Y. Kwok (Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong Special Administrative Region) K Kathy S. M. Leung (The Hong Kong Jockey Club Global Health Institute, Hong Kong Special Administrative Region) J Joseph T. Wu (The Hong Kong Jockey Club Global Health Institute, Hong Kong Special Administrative Region) C Cheuk-Kwong Lee (The Hong Kong Jockey Club Global Health Institute, Hong Kong Special Administrative Region) J Jane Davies (Menzies School of Health Research) P Pia S. Pannaraj (Division of Infectious Diseases, Children’s Hospital Los Angeles) E E. Kaity Allen (Department of Immunology, St. Jude Children’s Research Hospital) P Paul G. Thomas S Shidan Tosif (Infection and Immunity, Murdoch Children’s Research Institute) N Nigel W. Crawford (Infection and Immunity, Murdoch Children’s Research Institute) M Martha Lappas (Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne) I Irani Thevarajan (Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) S Sharon R. Lewin (Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) S Stephen J. Kent (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) J Jennifer A. Juno (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) K Katherine A. Bond (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) D Deborah A. Williamson (Victorian Infectious Diseases Service, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity) N Natasha E. Holmes (Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) O Olivia C. Smibert (Department of Infectious Diseases and Immunology, Austin Health) C Claire L. Gordon (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) J Jason A. Trubiano (Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) T Tom C. Kotsimbos (Department of Respiratory Medicine, The Alfred Hospital) A Allen C. Cheng (School of Public Health and Preventive Medicine, Monash University) C Claudia Efstathiou (National Heart and Lung Institute, Imperial College London) L Lance Turtle (Institute of Infection, Ecological and Veterinary Sciences, University of Liverpool & Liverpool University Hospital National Health Service Foundation Trust) R Ryan S. Thwaites (National Heart and Lung Institute, Imperial College London) C Christopher E. Brightling (Institute for Lung Health, Leicester NIHR BRC, University of Leicester) J Jamie Rossjohn M Matthew R. McKay (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) J Jinmin Tian (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention) W William Jun Liu (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention) G George Fu Gao (National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention) J Jianqing Xu (Shanghai Public Health Clinical Centre and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University) K Kyuto Sonehara K Ken J. Ishii (Laboratory of Adjuvant Innovation, Center for Vaccine and Adjuvant Research, National Institutes of Biomedical Innovation, Health and Nutrition, Saito Asagi) H Ho Namkoong Y Yukinori Okada M Malik Peiris (HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region) D David S. C. Hui (Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong) L Leo L. M. Poon (HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region) P Peter C. Doherty (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) T Thi H. O. Nguyen (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) S Sophie A. Valkenburg (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) K Katherine Kedzierska (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity)

Abstract

Understanding host factors driving asymptomatic versus severe disease outcomes is of key importance if we are to control emerging and re-emerging viral infections. HLA-B*15:01 has been associated with asymptomatic SARS-CoV-2 infection in nonhospitalized individuals of European ancestry, with protective immunity attributed to preexisting cross-reactive CD8 + T-cells directed against HLA-B*15:01-restricted Spike-derived S 919-927 peptide (B15/S 919 + CD8 + T-cells). However, fundamental questions remained on the abundance and clonotypic nature of CD8 + T-cell responses in HLA-B*15:01-positive patients who succumbed to life-threatening COVID-19. Here, we analyzed B15/S 919 + CD8 + T-cell responses in COVID-19 patients from independent HLA-typed COVID-19 patient cohorts across three continents, Australia, Asia and Europe. We assessed B15/S 919 + CD8 + T-cells in COVID-19 patients across disease outcomes ranging from asymptomatic to hospitalized critical illness. We found that severe/critical COVID-19 patients mounted B15/S 919 + CD8 + T-cell responses lacking a highly expanded key public B15/S 919 + CD8 + T-cell receptor (TCR; TRAV9-2/TRBV7-2) which recurred across multiple individuals in COVID-19 patients with a mild disease. Instead, B15/S 919 + CD8 + T-cell responses in life-threatening disease had a prevalence of an alternate TCR clonotypic motif (TRAV38-2/DV8/TRBV20-1), potentially contributing, at least in part, to why B15/S 919 + CD8 + T-cells in severe COVID-19 patients were less protective. Interestingly, the frequency, memory phenotype, and activation profiles of circulating B15/S 919 + CD8 + T-cells did not differ across disease severity. Moreover, B15/S 919 + CD8 + T-cells were better maintained into convalescence compared to other SARS-CoV-2-specificities. Our study thus provides evidence on the differential nature of the TCR clonal repertoire in 22.37% of HLA-B*15:01-positive COVID-19 patients who developed severe or critical disease in our cohorts, comparing to HLA-B*15:01-expressing individuals with mild COVID-19.

Article Details

Volume / Issue Vol. 122, Issue 36
Published September 09, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (59)

L

Louise C. Rowntree

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

L

Lilith F. Allen

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

R

Ruth R. Hagen

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

H

Hayley A. McQuilten

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

A

Ahmed A. Quadeer

Department of Electronic and Computer Engineering, School of Engineering, Hong Kong University of Science and Technology, Hong Kong Special Administrative Region

P

Priyanka Chaurasia

Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University

P

Prathanporn Kaewpreedee

HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region

K

Kelly W. K. Lee

HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region

C

Carolyn A. Cohen

HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region

J

Jan Petersen

Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University

D

Dene R. Littler

J

Jennifer R. Habel

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

W

Wuji Zhang

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

S

Samuel M. S. Cheng

Division of Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region

K

Ken Ka Pang Chan

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong

J

Janette S. Y. Kwok

Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong Special Administrative Region

K

Kathy S. M. Leung

The Hong Kong Jockey Club Global Health Institute, Hong Kong Special Administrative Region

J

Joseph T. Wu

The Hong Kong Jockey Club Global Health Institute, Hong Kong Special Administrative Region

C

Cheuk-Kwong Lee

The Hong Kong Jockey Club Global Health Institute, Hong Kong Special Administrative Region

J

Jane Davies

Menzies School of Health Research

P

Pia S. Pannaraj

Division of Infectious Diseases, Children’s Hospital Los Angeles

E

E. Kaity Allen

Department of Immunology, St. Jude Children’s Research Hospital

P

Paul G. Thomas

S

Shidan Tosif

Infection and Immunity, Murdoch Children’s Research Institute

N

Nigel W. Crawford

Infection and Immunity, Murdoch Children’s Research Institute

M

Martha Lappas

Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne

I

Irani Thevarajan

Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

S

Sharon R. Lewin

Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

S

Stephen J. Kent

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

J

Jennifer A. Juno

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

K

Katherine A. Bond

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

D

Deborah A. Williamson

Victorian Infectious Diseases Service, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity

N

Natasha E. Holmes

Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

O

Olivia C. Smibert

Department of Infectious Diseases and Immunology, Austin Health

C

Claire L. Gordon

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

J

Jason A. Trubiano

Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

T

Tom C. Kotsimbos

Department of Respiratory Medicine, The Alfred Hospital

A

Allen C. Cheng

School of Public Health and Preventive Medicine, Monash University

C

Claudia Efstathiou

National Heart and Lung Institute, Imperial College London

L

Lance Turtle

Institute of Infection, Ecological and Veterinary Sciences, University of Liverpool & Liverpool University Hospital National Health Service Foundation Trust

R

Ryan S. Thwaites

National Heart and Lung Institute, Imperial College London

C

Christopher E. Brightling

Institute for Lung Health, Leicester NIHR BRC, University of Leicester

J

Jamie Rossjohn

M

Matthew R. McKay

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

J

Jinmin Tian

National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention

W

William Jun Liu

National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention

G

George Fu Gao

National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention

J

Jianqing Xu

Shanghai Public Health Clinical Centre and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University

K

Kyuto Sonehara

K

Ken J. Ishii

Laboratory of Adjuvant Innovation, Center for Vaccine and Adjuvant Research, National Institutes of Biomedical Innovation, Health and Nutrition, Saito Asagi

H

Ho Namkoong

Y

Yukinori Okada

M

Malik Peiris

HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region

D

David S. C. Hui

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong

L

Leo L. M. Poon

HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region

P

Peter C. Doherty

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

T

Thi H. O. Nguyen

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

S

Sophie A. Valkenburg

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

K

Katherine Kedzierska

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity