Although the COVID-19 pandemic has left no country untouched there has been limited research to understand clinical and immunological responses in African populations. Here we characterise patients hospitalised with suspected (PCR-negative/IgG-positive) or confirmed (PCR-positive) COVID-19, and healthy community controls (PCR-negative/IgG-negative). PCR-positive COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-negative/IgG-positive and PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants exhibited a nasal and systemic cytokine signature analogous to PCR-positive COVID-19 participants, predominated by chemokines and neutrophils and distinct from PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants had increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. PCR-negative/IgG-positive individuals with high COVID-19 clinical suspicion had inflammatory profiles analogous to PCR-confirmed disease and potentially represent a target population for COVID-19 treatment strategies. Clinical management of COVID-19 in resource-poor settings has distinct challenges and detailed patient characterisation is needed. Here, the authors describe the clinical and immunological profiles of patients at a hospital in Malawi with confirmed and suspected COVID-19.
【저자키워드】 SARS-CoV-2, viral infection, clinical microbiology, Infectious-disease diagnostics, 【초록키워드】 COVID-19, Dexamethasone, Neutrophils, COVID-19 pandemic, hospital, neutrophil, nasal, chemokines, chemokine, clinical, management, African, Research, Patient, Control, Community, Clinical management, disease, Immunological response, antibiotic, Inflammatory, Streptococcus pneumoniae, Staphylococcus aureus, colonisation, target population, Treatment strategies, Participants, PCR-confirmed, profile, immunological profile, individual, clinical suspicion, PCR-positive, hospital discharge, participant, characterisation, PCR-negative, Beta-lactam, hospitalised, populations, country, healthy, exhibited, receive, systemic cytokine, 【제목키워드】 SARS-COV-2 infection, sub-Saharan Africa, Patient, Evidence, immunological profile,