Cellular immune responses in non-hospitalized COVID-19 cases undergoing pregnancy with immune modulation treatment

ABSTRACT

Introduction: In January 2020, the genome of the novel coronavirus, SARS-CoV-2, was sequenced, the etiologic RNA virus for COVID- 19. Several variants from the initial strain of SARS-CoV-2 have been reported, notably the Delta variant and most recently, the Omicron variant. However, how the virus affects the cellular immune system has been elusive. This study aims to investigate peripheral blood immunophenotype, natural killer (NK) cell cytotoxicity, and T helper (Th) 1/ Th2 ratios in pregnantwomen undergoing immunotherapy with a history of recurrent pregnancy losses (RPL) and repeated implantation failures (RIF). Materials and Methods: A prospective cohort study was performed on pregnant women with a history of RIF and RPL. The study group comprised 20 pregnant women with COVID-19, of whom eight had documented vaccinations. All were undergoing personalized immunemodulation and/or anticoagulation treatment. When they were diagnosed with COVID-19, immunomodulating medications were tapered off or decreased until recovery. Peripheral blood immunophenotype, NK cell cytotoxicity (NKC) at effector to target cell (E T) ratio at 501 and 251, and Th1/Th2 cell ratios (TNF-a/IL-10, IFN-g/IL-10 producing Th cell ratios)were measured by flow cytometry within 5weeks before and after COVID-19. Statistical analysis was performed by using the student t-test. Results: Peripheral blood immunophenotypes including % CD3 (77.38 ± 2.15 % vs. 79.98 ± 1.65 %, P = 0.34), % CD19 (13.63 ± 1.63 % vs. 12.63 ± 1.79 %, P = 0.68), % CD56 (7.61 ±1.32 % vs. 6.15± 1.08 %, P = 0.40), % CD19/CD5 (4.68 ±1.41 % vs. 4.17 ± 0.72 %, P = 0.75) were not significantly different before and after COVID- 19. NKC at E T ratio of 501 (Mean ±SE), before and after COVID- 19 were 21.16 ± 0.66% and 22.21 ± 1.06 % respectively (P = 0.40). NKC at E T cell ratios of 251 were 15.71 ± 0.69 % and 16.44 ± 0.93 % respectively (P = 0.52). TNF-a/IL-10 (29.61 ± 2.43 vs 28.95 ±2.06, P = 0.83) and IFN-g/IL-10 (16.36 ±2.22 vs 12.61 ± 0.94, P = 0.14) producing Th1/Th2 cell ratios were comparable before and after COVID-19. Conclusions: Our findings suggest that even though patients are affected by the COVID-19 during the Omicron phase, ©2022 The Authors. American Journal of Reproductive Immunology ©2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. there were no significant flares in cellular immune responses when patients recovered from COVID-19 in not hospitalized cases.