Abstract
Innate immune response, especially type 1 interferon (IFN) response is considered to play a substantial role in the outcome of SARS-CoV-2 infection. A reduced and delayed IFN response has been associated with progression to severe COVID-19. In this study, we investigated levels of circulating IFNα and serum neutralizing activity in COVID-19 patients admitted to the intensive care unit. We found a significant association of levels of IFNα with age (p = 0.007). This association has also been observed in a cohort of COVID-19 outpatients with mild infection (p = 0.02). The impact of senescence on IFN response can explain the higher susceptibility of the elderly to severe COVID-19.
Highlights
The COVID-19 pandemic has strained healthcare systems worldwide
In this study we investigated serum levels of IFNα and neutralizing antibodies, and associated factors in COVID-19 patients admitted to the intensive care units (ICU)
Two groups of patients were included in the study: (i) patients admitted to the ICU for COVID-19 between March and June 2020 with a positive SARS-CoV-2 RT-PCR result using nasopharyngeal and/or lower respiratory samples and a serum sample available within 7 days upon admission and (ii) COVID-19 outpatients with recent infection, and with a serum sample collected on the same day when the nasopharyngeal specimen collected and tested positive for SARS-CoV-2
Summary
The COVID-19 pandemic has strained healthcare systems worldwide. A major challenge has been management of the overwhelming influx of severe COVID-19 patients in hospitals, and especially the intensive care units (ICU). The pathogenesis of severe COVID19 is complex and combines factors such as hyperinflammatory responses and alterations in coagulation. Several clinical predictors of disease severity have been described such as older age, pre-existing comorbidities and hypoxia. Some markers of organ dysfunction (such as those of the heart, liver and kidneys) and non-specific markers including blood cells or coagulation abnormalities and levels of various cytokines have been associated to severe disease [1]. Despite significant variability in the severity of clinical presentation, the patterns of antiviral response probably impact the outcome of SARS-CoV-2 infection and the related immunopathogenesis [2]
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