Abstract
Objectives: A novel beta coronavirus has been identified as responsible for the 2019 coronavirus infection (Covid-19). Clinical presentations range from asymptomatic cases to acute respiratory distress syndrome with fatal outcome. Such a broad spectrum of disease expression calls for an investigation of immune response characteristics.
Methods: We identified subjects admitted for Covid-19 in whom a large panel of immunological markers were measured, including B- and T- and NK-lymphocyte phenotypes, T-lymphocyte subpopulation cells and plasma cytokines. Patients were divided according to symptom severity during hospitalisation, in those with uncomplicated and complicated infection. Differences between groups were analyzed.
Results: Seventeen patients were included (mean age: 83 years; 9 women; mean delay of symptoms onset: 4 days). Six had uncomplicated infection, while 11 developed complicated forms during hospitalization. CD10 + B lymphocyte levels were inversely correlated with clinical severity (5.8% vs 2.0%, p = 0.04) and CD10+ levels above 3% were independently associated with uncomplicated forms [Odds Ratio 0.04 (CI 0.002-0.795, p = 0.034)]. TNF-alpha, IL-1, Il-6 and Il-8 measurements upon admission differed between patients who died and those who survived (p < 0.01 for all comparisons).
Conclusions: In a population of elderly patients recently infected with Covid-19, CD10 + B cell levels were inversely correlated with clinical severity. Cytokine values upon admission were highly predictive of fatal outcome during hospitalisation. These findings could explain differences in the clinical presentation and allow rapid identification of patients at risk for complications.
Keywords: Clinical severity; Covid-19; Immune response.
【저자키워드】 COVID-19, immune response, Clinical severity, 【초록키워드】 Respiratory distress syndrome, Coronavirus infection, coronavirus, immune response, Cytokines, acute respiratory distress syndrome, Hospitalization, IL-6, Infection, risk, cytokine, Symptom, outcome, elderly patients, CD10, B cell, lymphocyte, Characteristics, clinical, Patient, Asymptomatic case, IL-8, Asymptomatic cases, complications, Alpha, plasma, Beta, group, TNF-alpha, hospitalisation, Admission, IL-1, B lymphocyte, acute respiratory distress, marker, Clinical severity, broad spectrum, Odds ratio, Elderly patient, Predictive, respiratory distress, Phenotypes, Clinical presentations, subject, Comparisons, syndrome, symptom severity, subpopulation, beta coronavirus, immunological, Cell, difference, disease expression, responsible, analyzed, died, form, correlated, explain, were measured, Ratio, those who survived, 【제목키워드】 immunological profile,