COVID-19 Research Paper Volume 13, Issue 23 pp 24943—24962

Impact of chemotherapy and immunotherapy on the composition and function of immune cells in COVID-19 convalescent with gynecological tumors

Tianyu Qin1,2, , Ensong Guo1,2, , Funian Lu1,2, , Yu Fu1,2, , Si Liu1,2, , Rourou Xiao1,2, , Xue Wu1,2, , Chen Liu1,2, , Chao He1,2, , Zizhuo Wang1,2, , Xu Qin1,2, , Dianxing Hu1,2, , Lixin You1,2, , Fuxia Li3, , Xi Li1,2,4, , Xiaoyuan Huang1,2, , Ding Ma1,2, , Xiaoyan Xu1,2, , Bin Yang1,2, , Junpeng Fan1,2, ,

  • 1 Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  • 2 Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  • 3 Department of Gynecology, Foshan Women and Children’s Hospital Affiliated to Southern Medical University, Foshan 528000, China
  • 4 Department of Cell, Development and Cancer Biology, Oregon Health and Sciences University, Portland, OR 97201, USA

Received: June 11, 2021       Accepted: November 22, 2021       Published: December 4, 2021
How to Cite

Copyright: © 2021 Qin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Ongoing pandemic and potential resurgence of Coronavirus disease 2019 (COVID-19) has prompted urgent efforts to investigate the immunological memory of convalescent patients, especially in patients with active cancers. Here we performed single-cell RNA sequencing in peripheral blood samples of 3 healthy donors (HDs), 4 COVID-19 patients (Covs) and 4 COVID-19 patients with active gynecological tumor (TCs) pre- and post- anti-tumor treatment. All Covs patients had recovered from their acute infection. Interestingly, the molecular features of PBMCs in TCs are similar to that in Covs, suggesting that convalescent COVID-19 with gynecologic tumors do not have major immunological changes and may be protected against reinfection similar to COVID-19 patients without tumors. Moreover, the chemotherapy given to these patients mainly caused neutropenia, while having little effect on the proportion and functional phenotype of T and B cells, and T cell clonal expansion. Notably, anti-PD-L1 treatment massively increased cytotoxic scores of NK cells, and T cells, and facilitated clonal expansion of T cells in these patients. It is likely that T cells could protect patients from SARS-CoV-2 virus reinfection and anti-PD-L1 treatment can enhance the anti-viral activity of the T cells.


COVID-19: Coronavirus disease 2019; HD: healthy donors; Covs: COVID-19 patients; TCs: COVID-19 patients with active gynecological tumor; SARS-CoV-2: severe acute respiratory syndrome coronavirus-2; ICIs: immune checkpoint inhibitors; scRNA-seq: single-cell RNA sequencing; PBMCs: peripheral blood mononuclear cells; DEGs: differential expressed genes; FDR: false discovery rate; PCC: Pearson correlation coefficient; TRA: TCR alpha chain; TRB: TCR beta chain; t-SNE: t-distributed stochastic neighbor embedding; NK: Natural killer cells; HSCs: hematopoietic stem cells; TNF: tumor necrosis factor; IFN: interferon; APC: antigen presenting cell; NF-κB: nuclear factor-κB; TP: paclitaxel and cisplatin regimen; PAC: cisplatin, doxorubicin, and cyclophosphamide; GO: gene ontology; DC: dendritic cells; TCR: T cell receptor.