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Immune Phenotyping Based on the Neutrophil-to-Lymphocyte Ratio and IgG Level Predicts Disease Severity and Outcome for Patients With COVID-19
Frontiers in molecular biosciences ; 7:157-157, 2020.
Article | WHO COVID | ID: covidwho-689155


A recently emerging respiratory disease named coronavirus disease 2019 (COVID-19) has quickly spread across the world This disease is initiated by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and uncontrolled cytokine storm, but it remains unknown as to whether a robust antibody response is related to clinical deterioration and poor outcome in COVID-19 patients


Anti-SARS-CoV-2 IgG and IgM antibodies were determined by chemiluminescence analysis (CLIA) in COVID-19 patients at a single center in Wuhan Median IgG and IgM levels in acute and convalescent-phase sera (within 35 days) for all included patients were calculated and compared between severe and non-severe patients Immune response phenotyping based on the late IgG levels and neutrophil-to-lymphocyte ratio (NLR) was characterized to stratified patients into different disease severities and outcomes


A total of 222 patients were included in this study IgG was first detected on day 4 of illness, and its peak levels occurred in the fourth week Severe cases were more frequently found in patients with high IgG levels, compared to those with low IgG levels (51 8 vs 32 3%;p = 0 008) Severity rates for patients with NLR(hi)IgG(hi), NLR(hi)IgG(lo), NLR(lo)IgG(hi), and NLR(lo)IgG(lo) phenotype were 72 3, 48 5, 33 3, and 15 6%, respectively (p < 0 0001) Furthermore, severe patients with NLR(hi)IgG(hi), NLR(hi)IgG(lo) had higher inflammatory cytokines levels including IL-2, IL-6 and IL-10, and decreased CD4+ T cell count compared to those with NLR(lo)IgG(lo) phenotype (p < 0 05) Recovery rates for severe patients with NLR(hi)IgG(hi), NLR(hi)IgG(lo), NLR(lo)IgG(hi), and NLR(lo)IgG(lo) phenotype were 58 8% (20/34), 68 8% (11/16), 80 0% (4/5), and 100% (12/12), respectively (p = 0 0592) Dead cases only occurred in NLR(hi)IgG(hi) and NLR(hi)IgG(lo) phenotypes


COVID-19 severity is associated with increased IgG response, and an immune response phenotyping based on the late IgG response and NLR could act as a simple complementary tool to discriminate between severe and non-severe COVID-19 patients, and further predict their clinical






Full text: Available Database: WHO COVID Type: Article Journal: Frontiers in molecular biosciences Clinical aspect: Prediction Year: 2020