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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.
Zhang, Bicheng; Zhou, Xiaoyang; Zhu, Chengliang; Song, Yuxiao; Feng, Fan; Qiu, Yanru; Feng, Jia; Jia, Qingzhu; Song, Qibin; Zhu, Bo; Wang, Jun.
  • Zhang B; Cancer Center, Renmin Hospital of Wuhan University, Hubei Provincial Research Center for Precision Medicine of Cancer, Wuhan, China.
  • Zhou X; Cardiac Care Unit, Renmin Hospital of Wuhan University, Wuhan, China.
  • Zhu C; Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
  • Song Y; Cancer Center, Renmin Hospital of Wuhan University, Hubei Provincial Research Center for Precision Medicine of Cancer, Wuhan, China.
  • Feng F; Cancer Center, Renmin Hospital of Wuhan University, Hubei Provincial Research Center for Precision Medicine of Cancer, Wuhan, China.
  • Qiu Y; Cancer Center, Renmin Hospital of Wuhan University, Hubei Provincial Research Center for Precision Medicine of Cancer, Wuhan, China.
  • Feng J; Cancer Center, Renmin Hospital of Wuhan University, Hubei Provincial Research Center for Precision Medicine of Cancer, Wuhan, China.
  • Jia Q; Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China.
  • Song Q; Cancer Center, Renmin Hospital of Wuhan University, Hubei Provincial Research Center for Precision Medicine of Cancer, Wuhan, China.
  • Zhu B; Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China.
  • Wang J; Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
Front Mol Biosci ; 7: 157, 2020.
Article in English | MEDLINE | ID: covidwho-689155
ABSTRACT

Introduction:

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.

Methods:

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.

Results:

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 NLRhiIgGhi, NLRhiIgGlo, NLRloIgGhi, and NLRloIgGlo phenotype were 72.3, 48.5, 33.3, and 15.6%, respectively (p < 0.0001). Furthermore, severe patients with NLRhiIgGhi, NLRhiIgGlo had higher inflammatory cytokines levels including IL-2, IL-6 and IL-10, and decreased CD4+ T cell count compared to those with NLRloIgGlo phenotype (p < 0.05). Recovery rates for severe patients with NLRhiIgGhi, NLRhiIgGlo, NLRloIgGhi, and NLRloIgGlo 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 NLRhiIgGhi and NLRhiIgGlo phenotypes.

Conclusions:

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 outcome.

Full text: Available Collection: International databases Database: MEDLINE Type: Article Language: English Journal: Front Mol Biosci Clinical aspect: Prediction / Prognosis Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Type: Article Language: English Journal: Front Mol Biosci Clinical aspect: Prediction / Prognosis Year: 2020