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Severe SARS-CoV-2 infection induces a distinct nasal cytokine profile

Ben Morton; Kayla Barnes; Catherine Anscombe; Khuzwayo Jere; Comfort Brown; James Nyirenda; Tamara Phiri; Ndaziona Peter Banda; Charlotte Van der veer; Kwazizira Samson Mndolo; Kelvin Mponda; Jamie Rylance; Chimota Phiri; Jane Mallewa; Mulinda Nyirenda; Grace Katha; Paul Kambiya; James Jafali; Henry Mwandumba; Stephen Gordon; Jenifer Cornick; Kondwani Charles Jambo; - Blantyre COVID-19 consortium.
Preprint en Inglés | PREPRINT-MEDRXIV | ID: ppmedrxiv-21251753
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 comprehensively characterise patients hospitalised with suspected or confirmed COVID-19, and healthy community controls. PCR-confirmed COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-/IgG+ and PCR-/IgG-participants. PCR-/IgG+ participants exhibited a nasal and systemic cytokine signature analogous to PCR-confirmed COVID-19 participants, but increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. We did not find evidence that HIV co-infection in COVID-19 participants was associated with mortality or altered cytokine responses. The nasal immune signature in PCR-/IgG+ and PCR-confirmed COVID-19 participants was distinct and predominated by chemokines and neutrophils. In addition, PCR-/IgG+ 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.