Publicaciones científicas

Immunological Biomarkers of Fatal COVID-19: A Study of 868 Patients

03-may-2021 | Revista: Frontiers in Immunology

Esperanza Martín-Sánchez  1   2   3   4 , Juan José Garcés  1   2   3   4 , Catarina Maia  1   2   3   4 , Susana Inogés  4   5   6 , Ascensión López-Díaz de Cerio  4   5   6 , Francisco Carmona-Torre  7   8   9 , Marta Marin-Oto  10 , Félix Alegre  7 , Elvira Molano  11 , Mirian Fernandez-Alonso  9   12 , Cristina Perez  2   3   4 , Cirino Botta  13 , Aintzane Zabaleta  1   2   3   4 , Ana Belen Alcaide  10 , Manuel F Landecho  7 , Marta Rua  12 , Teresa Pérez-Warnisher  14 , Laura Blanco  3   4 , Sarai Sarvide  2   3   4 , Amaia Vilas-Zornoza  2   3   4 , Diego Alignani  1   2   3   4 , Cristina Moreno  1   3   4 , Iñigo Pineda  7 , Miguel Sogbe  7 , Josepmaria Argemi  7 , Bruno Paiva  1   2   3   4 , José Ramón Yuste  7   8   9


Abstract

Information on the immunopathobiology of coronavirus disease 2019 (COVID-19) is rapidly increasing; however, there remains a need to identify immune features predictive of fatal outcome.

This large-scale study characterized immune responses to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection using multidimensional flow cytometry, with the aim of identifying high-risk immune biomarkers. Holistic and unbiased analyses of 17 immune cell-types were conducted on 1,075 peripheral blood samples obtained from 868 COVID-19 patients and on samples from 24 patients presenting with non-SARS-CoV-2 infections and 36 healthy donors.

Immune profiles of COVID-19 patients were significantly different from those of age-matched healthy donors but generally similar to those of patients with non-SARS-CoV-2 infections. Unsupervised clustering analysis revealed three immunotypes during SARS-CoV-2 infection; immunotype 1 (14% of patients) was characterized by significantly lower percentages of all immune cell-types except neutrophils and circulating plasma cells, and was significantly associated with severe disease.

Reduced B-cell percentage was most strongly associated with risk of death. On multivariate analysis incorporating age and comorbidities, B-cell and non-classical monocyte percentages were independent prognostic factors for survival in training (n=513) and validation (n=355) cohorts.

Therefore, reduced percentages of B-cells and non-classical monocytes are high-risk immune biomarkers for risk-stratification of COVID-19 patients.

CITA DEL ARTÍCULO  Front Immunol. 2021 May 3;12:659018.  doi: 10.3389/fimmu.2021.659018.  eCollection 2021.

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