Severe COVID-19 Research Articles

Immunopathological markers and cell types linked to COVID-19 symptom manifestation

BackgroundNumerous studies have investigated the molecular properties that contribute to the symptoms of COVID-19, such as the virus’s genetic makeup, its replication mechanisms, and how it interacts with host cells. However, identifying the immunopathological properties, such as the immune system’s response, cytokine levels, and the presence of specific biomarkers, that are associated with the severity of the infection remains crucial for developing effective treatments and preventions.MethodsWe analyzed blood protein factor profiles from 420 individuals to identify features differentiating between test-negative healthy, asymptomatic, and symptomatic individuals using statistical comparison and the least absolute shrinkage and selection operator (i.e., LASSO) algorithm. Additionally, we examined single-cell RNA sequencing data from 141 individuals to identify specific cell types associated with the COVID-19 symptoms.ResultsHealthy individuals who tested negative had distinct blood protein factor levels compared to asymptomatic individuals. We identified two key protein factors, Serpin A10 and Complement C9, that differentiate between asymptomatic and symptomatic patients. Symptomatic patients showed lower levels of CD4+ T naïve, CD4+ T effector & memory, and CD8+ T naïve cells, along with higher levels of CD14+ classical monocytes compared to asymptomatic patients. Additionally, CD16+ non-classical monocytes, major producers of C1QA/B/C, appeared to contribute to the observed Complement C9 levels.ConclusionsThese findings advance our understanding of the immunopathological mechanisms underlying COVID-19 and may inform the development of targeted therapies and preventative measures. Future research should focus on further elucidating these mechanisms and exploring their potential clinical applications in managing COVID-19 severity.

A Review of an Effective Deep Learning Network for Estimating COVID-19 severity from chest X-ray Imagery: Co Severity-Net

The COVID-19 pandemic has become an integral part of our existence and shows no signs of abating. In 2020, the World Health Organization declared it a pandemic, and its effects have impacted our lives in myriad ways. To detect COVID-19 from Chest X-Ray images, researchers have developed deep learning techniques. Given the severity of the disease, scoring the level of COVID-19 infection can aid in determining the optimal course of treatment and care for patients, as not all COVID-19 positive patients require specialized medical attention. However, the limited availability of a large-scale dataset has resulted in few studies being conducted to estimate the severity of the disease from Chest X-Ray images. Consequently, we propose CoV Severity-Net, a deep learning-based architecture trained on a public COVID-19 dataset curated by experienced radiologists for severity estimation. Our proposal is based on a review of 18 papers from reputable sources such as Google Scholar, PubMed, and Science Direct.

Relationship between Diet-Related Inflammation and Hospitalization Risk and Disease Severity in Patients with COVID-19

Background: Increased serum concentrations of inflammatory biomarkers in patients indicate a strong association between COVID-19 and inflammation. However, the association between diet-related inflammation and COVID-19 has been less investigated. The aim of this study is to investigate whether the inflammatory scores of the diet are associated with the severity of COVID-19 disease and the probability of hospitalization of patients. Methods: The authors conducted a cross-sectional study involving 141 patients with COVID-19. The empirical dietary inflammatory pattern (EDIP) and dietary inflammation scores (DIS) were calculated based on a 147-item semi-quantitative food frequency questionnaire. The association between serum levels of inflammatory biomarkers and diet-related inflammation was also investigated. Results: 74 inpatients and 87 outpatients participated in this study. Higher DIS scores were significantly associated with an increased risk of COVID-related hospitalization (Tertile3 vs. tertile1: OR = 3·62; 95 % CI 1·43 to 9·14, P=0·008 after fully adjustment). This association with EDIP was also observed, but it was not significant. Conclusion: The data from this provide evidence that a pro-inflammatory diet was associated with higher risk of hospitalization due to high severity of COVID-19.

Assessment of the disease course, diagnosis, and treatment of the new coronavirus infection in a Stavropol multidisciplinary hospital during the COVID-19 pandemic

Aim. To evaluate the disease course, laboratory diagnosis, and treatment results of COVID-19 patients. Materials and methods. In the period from January to December 2021, the moderate and severe COVID-19 forms complicated by polysegmental community-acquired pneumonia were monitored in 861 patients admitted to Stavropol Clinical City Hospital No. 3. Patients were assessed according to laboratory data, body mass index, concomitant diseases, gender, age, duration of inpatient treatment, and disease outcome. Results. More than half of the COVID-19 patients were overweight and had concomitant diseases at the time of admission, which significantly worsened the course and prognosis of the disease. The inflammation predictors (C-reactive protein, procalcitonin, fibrinogen, D-dimer, lactate dehydrogenase) were found to have an important role, with their indicators correlating significantly with the severity of the patient’s condition. Dynamic monitoring of these laboratory parameters served as a marker of the adequacy of the therapy; however, these were not always a criterion for prescribing antibacterial therapy. Bacteriological diagnostics was applied only in 9.4% of cases. Conclusion. Although the COVID-19 severity was not associated with gender, it correlated significantly with age and the presence of comorbid cardiovascular, bronchopulmonary, and endocrine diseases. A retrospective analysis revealed characteristic laboratory markers of the severity of COVID-19 infection. It was revealed that the initial empirical ABT was initiated in 94% of cases in the absence of reliable objective signs of bacterial infection.

Risk factors for SARS-CoV-2 infection and severe COVID-19 in unvaccinated solid organ transplant recipients

The role of immunosuppressive therapy on SARS-CoV-2 infection risk and COVID-19 severity remains unclear in unvaccinated solid organ transplant recipients. We included 1957 organ transplant recipients between July 2020 and April 2021 to analyze whether baseline immunosuppressive therapy and other risk factors are associated with SARS-CoV-2 infection and severe COVID-19. In total, 247 (12.6%) had SARS-CoV-2 (defined as positive nasopharyngeal swab and/or positive antibody titer). Of these, 57 (23.1%) had severe COVID-19, defined as oxygen supplementation, intensive care unit admission or death. Multivariable analysis identified diabetes (hazard ratio (HR) 1.39 (95% confidence interval (CI) 1.05–1.83)), chronic lung disease (HR 1.71 (95% CI 1.13–2.60)) and contact with a COVID-19 positive individual (HR 3.61 (95% CI 2.61–4.99) as independent risk factors for SARS-CoV-2 infection. There was no association between immunosuppressive therapy and infection risk. Severe COVID-19 was multivariably associated with hypertension (OR 5.45 (95% CI 1.66–17.84)), chronic kidney disease (OR 3.55 (95% CI 1.75–7.19)), corticosteroid use (OR 2.93 (95% CI 1.03–2.55)) and having a COVID-19 positive housemate (OR 6.77 (95% CI 2.65–17.28)). In conclusion, baseline corticosteroid use, but no other immunosuppressive agent, is independently associated with severe COVID-19 in unvaccinated SOT recipients after correction for hypertension, chronic kidney disease, housemates affected by COVID-19 and transplant type.

Impact of COVID-19 severity on sleep parameters, exercise tolerance, respiratory muscle strength, pulmonary function, and quality of life: a cross-sectional study

Impact of COVID-19 severity on sleep parameters, exercise tolerance, respiratory muscle strength, pulmonary function, and quality of life: a cross-sectional study

Genetic variations in Interferon-Induced with Helicase C Domain 1: Impact on COVID-19 risk and severity in the Moroccan population

BackgroundThe clinical spectrum of COVID-19 varies considerably, ranging from asymptomatic cases to severe disease and even death. This variability can partly be attributed to genetic differences in genes associated with inflammation and immune responses. Among these genes, Interferon Induced with Helicase C Domain 1 (IFIH1), which codes for a cytoplasmic sensor, plays a crucial role in detecting SARS-CoV-2 viral RNA and initiating the antiviral interferon (IFN) response, thereby constituting a key element of innate immune defense. AimThis study aims to examine the association between genetic variants in the IFIH1 gene and susceptibility to, as well as the severity of, COVID-19 in the Moroccan population. Materials and MethodsWe conducted a case-control study involving 299 COVID-19 positive patients (149 severe, 150 benign) and 145 uninfected-SARS-CoV-2 controls. We determined the genotypes of two functional variants, rs1990760 (Ala946Thr) and rs3747517 (His843Arg), in the IFIH1 gene using predesigned TaqMan real-time allelic discrimination assay. ResultsOur results indicated that the TT genotype of rs1990760 was associated with increased susceptibility to SARS-CoV-2 under a recessive model (odds ratio [OR] = 2.22, 95 % confidence interval [CI] 1.28–3.84, P=0.003). Conversely, the CT genotype appeared to confer protection against SARS-CoV-2 infection (OR=0.58, 95 % CI 0.38–0.91, P=0.016) and COVID-19 severity (OR=0.56, 95 % CI 0.34–0.91, P=0.019). No significant association was found between rs3747517 and the risk of hospitalization or infection susceptibility. ConclusionThese findings underscore the significance of genetic variability in the IFIH1 gene in shaping individual responses to SARS-CoV-2 in the Moroccan population.

Clinical and Epidemiological Features of Pediatric COVID-19: A Retrospective Study.

There is a demand for additional data regarding the impact of coronavirus disease 2019 (COVID-19) on the pediatric population. This study sought to determine the clinical and epidemiological features of pediatric COVID-19 in Iran. A retrospective study was performed to assess medical records of children with COVID-19 admitted to Abuzar Hospital in Ahvaz (Iran). Their clinical and demographic data were recorded. In this study, 600 medical records of pediatric COVID-19 patients were evaluated. Over 50% of them were boys. Mild, moderate, and severe manifestations of COVID-19 were identified in 250, 200, and 150 children, respectively. Patients with severe or moderate COVID-19 had substantially higher levels of various inflammatory markers (C-reactive protein (CRP), fibrinogen, and d-dimer), alanine transaminase (ALT), creatine kinase (CPK), blood urea nitrogen (BUN), neutrophils, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatinine (Cr), bilirubin, and gamma-glutamyl transferase (GGT) compared to children with mild COVID-19 (p < 0.001); they also had lower levels of lymphocytes, hemoglobin (Hb), and vitamin D than patients with mild COVID-19 (p < 0.001). In addition, children with severe or moderate COVID-19 had a notably higher incidence of fever or dry cough and longer hospital stays than those with mild COVID-19 (p < 0.001). The prevalence of malnutrition and anemia in patients was 50.6% and 31.5%, respectively. A significant proportion of children who were underweight and stunted experienced moderate to severe COVID-19. Furthermore, there was a considerably higher prevalence of malnutrition, anemia, and vitamin D insufficiency, or deficiency in children with moderate-to-severe COVID-19 compared to patients with mild COVID-19 (p < 0.001). The outcomes of this study revealed a significantly higher prevalence of malnutrition, anemia, vitamin D insufficiency or deficiency, elevated liver and kidney function test results, and increased inflammatory markers in children with moderate to severe COVID-19 compared to those with mild COVID-19.

Integrated Analysis of Noncoding RNAs (PVT-1 and miR-200c) and Their Correlation with STAT4/IL-6 Axis as Reliable Biomarkers for COVID-19 Severity.

Inefficient control of elevated inflammatory mediators in coronavirus disease 2019 (COVID-19) has led to health complications, prompting the exploration of efficient biomarkers for monitoring this condition. We herein sought to investigate the implications of plasmacytoma variant translocation 1 (PVT-1), microRNA-200c (miR-200c), signal transducer and activator of transcription 4 (STAT-4), and interleukin-6 (IL-6), as well as how they correlated with creatinine, C-reactive protein (CRP), and lactate dehydrogenase (LDH) activity to identify biomarkers able to the early prognosis and diagnosis of COVID-19. Our study included a total of 105 infected COVID-19 patients and 35 healthy subjects as controls. Individuals with COVID-19 showed a significant increase in CRP, creatinine, and LDH activity. In addition, COVID-19 patients exhibited significantly higher levels of IL-6. These patients also demonstrated notably elevated expressions of miR-200c and PVT-1. The expression level of STAT4 decreased in the COVID-19 patients, and this decrease was negatively correlated with creatinine and LDH activity. The levels of miR-200c and PVT-1 expressions, and their connections with IL-6 and STAT4 levels, increased significantly with the severity of COVID-19 cases. In addition, receiver operating characteristic analysis showed that PVT-1 and miR-200c could be reliable biomarkers for determining the severity of COVID-19.

The HLA-B -21 M/T dimorphism associates with disease severity in COVID-19.

Host genetics shape immune responses and influence severity of infectious diseases. The HLA-B -21 M/T dimorphism tunes the functionality of natural killer (NK) cells expressing the inhibitory receptor NKG2A. NKG2A+ NK cells have been reported to recognize SARS-CoV-2-infected cells, but it remains unclear whether the HLA-B -21 M/T dimorphism associates with COVID-19 severity. Here, we investigated the influence of the HLA-B -21 M/T dimorphism in a cohort of 230 unvaccinated patients hospitalized with COVID-19 and requiring respiratory support. We found that HLA-B -21 M/M genotypes were more prevalent in patients with moderate compared to severe COVID-19 (6.0% vs. 0.9%). Comparison of age- and sex-matched sub-groups revealed that patients with M/M genotypes required mechanical respiratory support less frequently (OR = 0.13, 95% CI = 0.01-0.76, P = 0.013). Furthermore, patients with M/M genotypes showed a coordinately shifted signature of clinical laboratory parameters, coinciding with elevated serum levels of the anti-viral cytokine IFN-γ. These findings demonstrate that HLA-B variants associate with COVID-19 severity and suggest that the robust functionality of NKG2A+ NK cells in patients carrying the M/M genotype may contribute to protection from severe disease.

Deciphering the Covid-19 Density Puzzle: A Meta-analysis Approach

The COVID-19 pandemic has sparked widespread efforts to mitigate its transmission, raising questions about the role of urban density in the spread of the virus. Understanding how city density affects the severity of communicable diseases like COVID-19 is crucial for designing sustainable, pandemic-resilient cities. However, recent studies on this issue have yielded inconsistent and conflicting results. This study addresses this gap by employing a comprehensive meta-analytic approach, synthesizing data across diverse regions and urban contexts to offer a broader, more nuanced perspective on the impact of city density. A systematic meta-analysis was conducted, initially screening 2,452 studies from Google Scholar, Scopus, and Avery Index databases (up to August 31, 2023), and narrowing down to 63 eligible studies. Using the restricted maximum likelihood (REML) method with a random effects model, the study accounted for variations across different studies. Statistical tests, file drawer analysis, and influence measure analysis were performed, along with assessments of heterogeneity and publication bias through forest and funnel plots. Despite this extensive analysis, the findings indicate that city density has a negligible effect on the severity of COVID-19, challenging the prevailing assumptions in the literature.

Circulating inflammatory cytokines predict severity disease in hospitalized COVID-19 patients: a prospective multicenter study of the European DRAGON consortium

BackgroundCOVID-19 has put a huge strain on the healthcare systems worldwide, requiring unprecedented intensive care resources. There is still an unmet clinical need for easily available biomarkers capable of predicting the risk for severe disease. The main goal of this prospective multicenter study was to identify biomarkers that could predict ICU admission and in-hospital mortality. MethodsWe prospectively recruited COVID-19 PCR positive patients in two hospitals, in Belgium and Italy. Blood samples were collected at hospital admission and 20 potential biomarkers were measured with the Luminex technology. Logistic regression models were performed to identify the biomarkers that, alone or together, were associated with patient disease severity. ResultsOur study demonstrates that elevated levels of circulating inflammatory cytokines were associated with disease severity in COVID-19 hospitalized patients. CXCL10, IL-4, IL-6 and MCP-1 values were predictive of ICU admission. Elevated levels of IL-6 and MCP-1 were also associated with in hospital death in COVID-19 hospitalized patients. ConclusionAltogether, elevated and correlated inflammatory cytokines in the blood of COVID-19 patients at hospital admission are predictive of disease severity and suggest a dysregulated inflammation induced by SARS-CoV-2 infection.

Effectiveness of Original Monovalent and Bivalent COVID-19 Vaccines Against COVID-19-Associated Hospitalization and Severe In-Hospital Outcomes Among Adults in the United States, September 2022-August 2023.

Assessments of COVID-19 vaccine effectiveness are needed to monitor the protection provided by updated vaccines against severe COVID-19. We evaluated the effectiveness of original monovalent and bivalent (ancestral strain and Omicron BA.4/5) COVID-19 vaccination against COVID-19-associated hospitalization and severe in-hospital outcomes. During September 8, 2022 to August 31, 2023, adults aged ≥ 18 years hospitalized with COVID-19-like illness were enrolled at 26 hospitals in 20 US states. Using a test-negative case-control design, we estimated vaccine effectiveness (VE) with multivariable logistic regression adjusted for age, sex, race/ethnicity, admission date, and geographic region. Among 7028 patients, 2924 (41.6%) were COVID-19 case patients, and 4104 (58.4%) were control patients. Compared to unvaccinated patients, absolute VE against COVID-19-associated hospitalization was 6% (-7%-17%) for original monovalent doses only (median time since last dose [IQR] = 421 days [304-571]), 52% (39%-61%) for a bivalent dose received 7-89 days earlier, and 13% (-10%-31%) for a bivalent dose received 90-179 days earlier. Absolute VE against COVID-19-associated invasive mechanical ventilation or death was 51% (34%-63%) for original monovalent doses only, 61% (35%-77%) for a bivalent dose received 7-89 days earlier, and 50% (11%-71%) for a bivalent dose received 90-179 days earlier. Bivalent vaccination provided protection against COVID-19-associated hospitalization and severe in-hospital outcomes within 3 months of receipt, followed by a decline in protection to a level similar to that remaining from previous original monovalent vaccination by 3-6 months. These results underscore the benefit of remaining up to date with recommended COVID-19 vaccines.

Effectiveness of pulmonary rehabilitation in post-COVID-19 patients: A pre- and post-interventional study.

The need of pulmonary rehabilitation (PR) for COVID-19 patients with long-term effects was desperately felt. The study's objective was to measure the effect of PR on functional capacity and health-related quality of life (HRQOL) in patients with post COVID conditions. Pulmonary medicine department of a teaching hospital conducted this pre-experimental study. The patient underwent a pre and post-assessment, including a six-minute walk test (6MWT) measuring distance, oxygen desaturation, pulse rate, and HRQOL. The intervention had six components; education to patients and caregivers, breathlessness relieving exercises, postural correction, aerobic training, strength training, and stretching exercises. These activities were carried out twice a week for eight weeks, supervised, unsupervised in homes, and a combination. The study enrolled 155 post-COVID patients (Males, 102 and female, 53), out of which 28 (18.1%) had mild, 55 (35.5%) had moderate and 72 (46.5%) had severe COVID. Paired t-test showed improvement in resting pulse rate (P = 0.001) and resting oxygen saturation (P < 0.0001). Distance walking for six minutes increased after rehabilitation (P < 0.0001). After eight weeks of pulmonary rehabilitation, there was an improvement (P < 0.001) in all domains of quality of life, that is, mobility, self-care, pain and discomfort, usual activity, sleep, anxiety and depression. Pulmonary rehabilitation is beneficial for post-COVID patients in improving their quality of life and six-minute walk test parameters, resulting in improved functional capacity and overall quality of life.

Addressing data quality issues to assess clinical and epidemiological risk factors for COVID-19 among documented cases in Liberia: a single-centre, retrospective, observational study

IntroductionIdentification of risk factors for severe COVID-19 can help to inform case management in resource-constrained settings. We aimed to rigorously but retroactively address data issues to identify risk factors for...

A retrospective cohort study on the association between nutritional status and prognosis in COVID-19 patients with severe and critical infection.

To evaluate the relationship between nutritional scoring systems, nutritional support methods, and the prognosis of severe and critically ill patients infected with the Omicron variant of coronavirus disease 2019 (COVID-19). Patients with confirmed Omicron variant severe and critical COVID-19, who were admitted to Chongqing Medical University First Hospital between December 2022 and January 2023, were enrolled into this retrospective study. Clinical data of patients who survived for 28 days were compared with those who died during the same period. Nutritional status was assessed using the 2002 Nutrition Risk Screening (NRS) tool and Prognostic Nutritional Index (PNI). Factors influencing patient mortality were identified by multivariate logistic regression, and the relationship between patient nutrition and mortality as the disease progressed was illustrated using Kaplan-Meier curves. The study was registered on the ChiCTR platform (No. ChiCTR2300067595). A total of 508 patients were included (349 survivors and 159 non-survivors). Significant differences were found in sex, age, NRS score, PNI score, albumin level, lymphocyte count, chronic comorbidities, mechanical ventilation, neutrophil count, procalcitonin, and platelet count between survivors and non-survivors. Multivariate analysis revealed that high NRS score (OR 3.87, 95% CI, 1.97, 7.63), fourth-level nutritional support (combined enteral and parenteral nutrition; OR 7.89, 95% CI, 1.32, 47.28), chronic comorbidities (OR 4.03, 95% CI, 1.91, 8.51), and mechanical ventilation (OR 6.03, 95% CI, 3, 12.13) were risk factors for mortality (OR > 1). The malnutrition rate among patients with NRS ≥ 3 was 41.93%. The median (interquartile range) PNI score was 38.20 (35.65, 41.25) for survivors versus 32.65 (29.65, 36.58) for non-survivors. The mortality rate was higher in patients with high nutritional risk within 28 days of hospitalization. The descending order for mortality rate in patients receiving different nutritional support was: dual parenteral and enteral nutrition, no nutritional intervention, single enteral nutrition, and single parenteral nutrition. A high proportion of severe and critically ill patients with COVID-19 experience malnutrition, and various factors are associated with their prognosis. High nutritional risk is significantly related to patient mortality. Early assessment using NRS or PNI is crucial for these patients, and personalized interventions should be implemented to improve overall nutritional status, maintain organ function, and enhance the body's antiviral defence.

Factors associated with severity and mortality of COVID-19 in French patients with connective tissue diseases and rheumatoid arthritis: a nation-wide, population-based analysis of the French national medico-administrative SNDS database

Factors associated with severity and mortality of COVID-19 in French patients with connective tissue diseases and rheumatoid arthritis: a nation-wide, population-based analysis of the French national medico-administrative SNDS database

Autoantibodies Directed Against Interferon Alpha, Nuclear Antigens, Cardiolipin, and Beta 2 Glycoprotein 1 Are Not Induced By SARS-CoV-2 or Associated with Long COVID

Autoantibodies (AAbs) directed against interferon alpha (aIFNα), nuclear antigens (ANAs), cardiolipin (aCL), and beta 2 glycoprotein 1 (aβ2GP1), have been demonstrated to significantly correlate with the severity of acute COVID-19. However, whether SARS-CoV-2 infection induces these AAbs and whether they are associated with long COVID remains unclear. The potential induction of aIFNα, ANAs, aCL, and aβ2GP1 by SARS-CoV-2 was assessed by measuring these AAbs in 224 pre- and post-infection paired serum samples from the Johns Hopkins Hospital Emergency Department (JHHED). The relationship between these AAbs and long COVID was assessed using 60 serum samples from participants in the Outpatient SARS-CoV-2 Mild and Asymptomatic Infection Response and Transmission (OutSMART) study. We found no evidence that these AAbs were induced in the JHHED cohort and no significant difference in their prevalence between patients with (n=30) and without (n=30) long COVID in the OutSMART cohort. These findings do not support the hypotheses that SARS-CoV-2 induces these AAbs or that they are related to long COVID.

Impact of SARS-CoV-2 Variants on COVID-19 Symptomatology and Severity during five waves.

BackgroundSARS-CoV-2 variants have distinct features of transmissibility, infectivity, and aggressiveness that may cause different clinical manifestations. A better understanding of the disease presentation and progression could help to outline more precise preventive and treatment frameworks. This study describes the differences in COVID-19 presentation and outcomes across five variant waves. MethodsThis prospective cohort was conducted in Serrana, São Paulo State, Brazil. Clinical and demographic data was obtained from June 2020 to December 2022 as part of an enhanced health surveillance system for COVID-19, based on increasing access to diagnostic testing for SARS-CoV-2 and patient follow-up. Individuals were assessed for COVID-19 symptoms and comorbidities. Mild cases were followed up for at least 14 days, and severe cases until discharge or death. Samples were genetically sequenced, and variant waves were determined based on global SARS-CoV-2 variant predominance (>90% sequenced samples), being as follows: Ancestral, Delta, Gamma, Omicron BA.1, and Omicron BA.2 waves. The relationship between clinical data and disease outcomes was analyzed in each variant wave. ResultsPatients infected during the Delta wave were the youngest (36.1 ± 18.2 years, p<0.001). The proportion of female patients was higher across all waves. Positivity rate, disease severity, and COVID-19-related deaths varied among them. Ageusia and anosmia were related to SARS-CoV-2 positivity during the Ancestral, Gamma, and Delta waves but not in Omicron BA.1 and Omicron BA.2 waves. Diarrhea presented a lower chance of positivity only in Omicron BA.1 and Omicron BA.2. Dyspnea was the most consistent risk factor for severity across all waves. ConclusionsAlthough patients with COVID-19 from different SARS-CoV-2 variants shared some clinical-epidemiological characteristics, each variant presented distinguishable features related to positivity and severity. This could help to understand the dynamics of COVID-19 variants and update recommendations for clinical practice.

Differential gene expression of immune response in COVID-19 and its relationship with progression of COVID-19

Human immune response evolved in virus clearance and gene expression levels of immune response may be associated with progression of Coronavirus disease 2019 (COVID-19). Our current study aims to investigate the relationship between differential gene expression of immune response and progression of COVID-19. A total of 50 participants of COVID-19 group were studied, compared with 39 participants of healthy control group. There were different gene expression profiles in pathways of activation of neutrophil, defense response and adaptive immune response for COVID-19 group before treatment compared to the healthy control group. Distinct gene expression profiles showed that pathways of chemotaxis, immune response and antibacterial humoral response involved in rehabilitation of severe COVID-19 group while pathways of immune system process, defense response to virus and negative regulation of viral genome replication involved in rehabilitation of moderate COVID-19 group. Both protein expression of ATP-binding cassette transporter A1 levels and protein expression of low affinity Fc-receptor FcγRIIIb levels were significantly and positively correlated with COVID-19-IgM levels and might be suitable as biomarkers for monitoring of COVID-19. This study showed that differential gene expression of immune response predicted onset and rehabilitation of COVID-19.