Post-acute COVID-19 associated with evidence of bystander t-cell activation and a recurring antibiotic-resistant bacterial pneumonia

Michaela Gregorova, Daniel Morse, Tarcisio Brignoli, Joseph Steventon, Fergus Hamilton, Mahableshwar Albur, David Arnold, Matthew Thomas, Alice Halliday, Holly Baum, Christopher Rice, Matthew B. Avison, Andrew D. Davidson, Marianna Santopaolo, Elizabeth Oliver, Anu Goenka, Adam Finn, Linda Wooldridge, Borko Amulic, Rosemary J. BoytonDaniel M. Altmann, David K. Butler, Claire McMurray, Joanna Stockton, Sam Nicholls, Charles Cooper, Nicholas Loman, Michael J. Cox, Laura Rivino*, Ruth C. Massey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Here, we describe the case of a COVID-19 patient who developed recurring ventilator- associated pneumonia caused by Pseudomonas aeruginosa that acquired increasing levels of antimicrobial resistance (AMR) in response to treatment. Metagenomic analysis revealed the AMR genotype, while immunological analysis revealed massive and escalating levels of T-cell activation. These were both SARS-CoV-2 and P. aeruginosa specific, and bystander activated, which may have contributed to this patient’s persistent symptoms and radiological changes.

Original languageEnglish
Article numbere63430
Pages (from-to)1-13
Number of pages13
Publication statusPublished - Dec 2020

Bibliographical note

Funding Information:
We would like to thank Kapil Gupta and Imre Berger for kindly providing us the spike protein, Natalie Di Bartolo and Ashley Toye for kindly providing us the N protein, both used for the SARS-CoV-2 serology work. The authors wish to acknowledge the assistance of Dr. Andrew Herman and Helen Rice and the University of Bristol Faculty of Biomedical Sciences Flow Cytometry Facility. We would also like to thank Keith Jolley and the Bristol University UNCOVER team for helpful discussions during the execution of this work and preparation of the manuscript. This work was supported by donations to Southmead Hospital Charity (Registered Charity Number: 1055900), by the Wellcome Trust (reference number: 212258/Z/18/Z) and by the Elizabeth Blackwell Institute, University of Bristol, with funding from the University’s alumni and friends. DKB is supported by a Cystic Fibrosis Trust PhD studentship (CF Trust SRC 015). RJB and DMA are supported by UKRI (MR/S019553/1 and MR/ R02622X/1)

Publisher Copyright:
© Gregorova et al.

Copyright 2021 Elsevier B.V., All rights reserved.

ASJC Scopus subject areas

  • Neuroscience(all)
  • Immunology and Microbiology(all)
  • Biochemistry, Genetics and Molecular Biology(all)


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