ABSTRACT
DCs regulate humoral immunity against SARS-CoV-2 by regulating CD4 + T cell activation, but the relations between DC phenotypes and functions and anti-RBD antibodies are unclear. We conducted this observational study in Huashan Hospital using a third 6.5U BBIBP-CorV or 25 µg ZF2001 administered at an interval of 4 to 8 months following the previous two doses in healthy adults. anti-RBD response and neutralizing titers against SARS-CoV-2 and VOCs were examined. DC maturation markers and pattern recognition receptors and cytokines produced by DC were measured, and DC function was tested in mixed lymphocyte reaction(MLR). Mean anti-RBD Ab and IgG rose from 22.08 and 9.17 on D0 to 4704.18 and 798.11 on D14(BAU/ml). Meanwhile, the surrogate virus neutralization test(sVNT) elevated from 17.15 on D0 to 2538.83 on D14. The expression of DC maturation markers on D3 and MLR were negatively correlated to sVNT, anti-RBD antibody, and IgG titers on D14(Spearman r=-0.558~-0.326) and D28(Spearman r=-0.615~-0.397), but positively correlated to IgG/Ab ratio(Spearman r = 0.249 ~ 0.509). DC function in activating T cells was also negatively related to anti-RBD antibody titer on D28(r=-0.532~-0.453, p = 0.015 ~ 0.035), and positively correlated with the proportion of anti-RBD IgG in Ab(r = 0.490 ~ 0.561, p = 0.010 ~ 0.032). DC-SIGN level showed a relation to antibody titer and IgG proportion opposite to DC maturation and function and was negatively related to the level of IL-10 produced by DCs. Our research suggested that DCs controlled CD4 + T cells in differentiating into regular T cells, and DC-SIGN might restrain T regular cells by suppressing IL-10 production of DC in anti-SARS-CoV-2 vaccination.
ABSTRACT
In this study, we aimed to explore whether Lymphocyte-C-reactive protein ratio (LCR) can differentiate disease severity of Coronavirus disease 2019 (COVID-19) patients and its value as an assistant screening tool for admission to the hospital and the intensive care unit (ICU). A total of 184 adult COVID-19 patients from the COVID-19 Treatment Center in Heilongjiang Province at the First Affiliated Hospital of Harbin Medical University between January 2020 and March 2021 were included in this study. Patients were divided into asymptomatic infection group, mild group, moderate group, severe group, and critical group according to the Diagnosis and Treatment of New Coronavirus Pneumonia (9th edition). Demographic and clinical data including gender, age, comorbidities, severity of COVID-19, white blood cell count (WBC), neutrophil proportion (NEUT%), lymphocyte count (LYMPH), lymphocyte percentage (LYM%), red blood cell distribution width (RDW), platelet (PLT), C-reaction protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (SCr), albumin (ALB), total bilirubin (TB), direct bilirubin (DBIL), indirect bilirubin (IBIL), and D-Dimer were obtained and collated from medical records at admission, from which sequential organ failure assessment (SOFA) score and LCR were calculated, and all above indicators were compared among groups. Multiple clinical parameters, including LYMPH, CRP and LCR, showed significant differences among groups. The related factors to classify COVID-19 patients into moderate, severe and critical groups included age, number of comorbidities, WBC, LCR, and AST. Among these factors, number of comorbidities showed the greatest effect, and only WBC and LCR were protective factors. The area under the receiver operating characteristic (ROC) curve of LCR to classify COVID-19 patients into moderate, severe and critical groups was 0.176. The cut-off value of LCR, and the sensitivity and specificity of ROC curve were 1780.7050, 84.6% and 66.2%, respectively. The related factors to classify COVID-19 patients into severe and critical groups included number of comorbidities, PLT, LCR, and SOFA score. Among these factors, SOFA score showed the greatest effect, and LCR was the only protective factor. The area under ROC curve of LCR to classify COVID-19 patients into severe and critical groups was 0.106. The cut-off value of LCR and the sensitivity and specificity of ROC curve were 571.2200, 81.3% and 90.0%, respectively. In summary, LCR can differentiate disease severity of COVID-19 patients and serve as a simple and objective assistant screening tool for hospital and ICU admission.