Abstract
SARS-CoV-2 is the novel coronavirus responsible for the current COVID-19 pandemic. Severe complications are observed only in a small proportion of infected patients but the cellular mechanisms underlying this progression are still unknown. Comprehensive flow cytometry of whole blood samples from 54 COVID-19 patients reveals a dramatic increase in the number of immature neutrophils. This increase strongly correlates with disease severity and is associated with elevated IL-6 and IP-10 levels, two key players in the cytokine storm. The most pronounced decrease in cell counts is observed for CD8 T-cells and VD2 γδ T-cells, which both exhibit increased differentiation and activation. ROC analysis reveals that the count ratio of immature neutrophils to VD2 (or CD8) T-cells predicts pneumonia onset (0.9071) as well as hypoxia onset (0.8908) with high sensitivity and specificity. It would thus be a useful prognostic marker for preventive patient management and improved healthcare resource management.
Highlights
SARS-CoV-2 is the novel coronavirus responsible for the current COVID-19 pandemic
A total of 54 patients with laboratory-confirmed SARS-CoV-2 infection were recruited at the National Centre for Infectious Diseases (NCID), Singapore from end March to mid-May 2020 (Supplementary Table 1)
Blood was collected from 54 patients upon enrolment at a median 7 days post-illness onset (Supplementary Table 1), from 28 patients who had recovered from COVID-19 disease (Supplementary Table 1) and 19 healthy donors (Supplementary Table 2)
Summary
SARS-CoV-2 is the novel coronavirus responsible for the current COVID-19 pandemic. Severe complications are observed only in a small proportion of infected patients but the cellular mechanisms underlying this progression are still unknown. The study focuses on a cohort of 54 COVID-19 patients who presented with varied clinical manifestations ranging from mild to fatal outcomes during the ongoing SARS-CoV-2 pandemic in Singapore This comprehensive immunophenotyping identifies immature neutrophils, CD8 T-cells and gamma delta (VD) 2 T-cells as key immune cell populations that undergo substantial changes in the cell counts across the spectrum of clinical severity. Their numbers, represent an early and robust prognosis value as shown by receiver operating characteristics (ROC) analysis
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