DIAGNOSIS AND PROGNOSIS SIGNIFICANCE OF IMMUNOLOGICAL MARKERS IN MIDDLE AND SEVERE COVID-19: META-ANALYSIS

  • Tetiana Mamontova Poltava State Medical University, PhD, Proff. Assoc., Department of Physiology
Keywords: COVID-19, lymphocytes, complement components, interleukins, immunoglobulins

Abstract

Background. COVID-19 continues to be an urgent medical and social problem of unprecedented proportions for the health care system in Ukraine. Currently, there is an increase in the prevalence of morbidity and mortality from COVID-19. Therefore, it is necessary to determine immunological markers of stratification of patients at high risk of complications and mortality.
The aim: to conduct a meta-analysis of immunological markers to identify predictors of mild or severe COVID-19.
Materials and methods. Meta-analysis of 16 electronic publications in PubMed, Google Scholar, medRXiV by keywords “COVID-19” or “2019-nCoV” or “SARSCoV- 2”, “immune markers” in the period from 2019 to 2022. The meta-analysis included publications on a clinical examination of 1731 patients with COVID-19, divided into 2 groups: the first -with mild (n = 1055) and the second –with severe (n = 679) Sars-CoV-2 infection. Statistical data processing by meta-analysis, non-parametric Student’s t-test and criterion χ2.
Research results and their discussion. There are was significantly higher mean age and proportion of males in patients with severe COVID-19 than in patients with mild COVID-19 (p = 0.0001; p = 0.009, respectively). Significantly lower absolute values of CD3+ (-1.02; CI [-1.443, -0.59]; p = 0.004), CD3+ CD4+(-1.34; CI [-2.117, -0.569]; p = 0.0007), CD3+CD8+(-1.49; CI [-2.244, -0.728]; p = 0.0001) T-lymphocytes, CD16+CD56+ natural killers (-1.02; CI [-1.904, -0.138]); p = 0,02), CD19+ B-lymphocytes (-1.12; CI [-2.077, -0.156]; p = 0.023), complement component C1q (-1.94; CI [-3.693, -0.182]; p = 0.03) and C3 (-2.93; CI [-5.422, -0.444]; p = 0.02), as well as significantly higher indicators of IL-6 (1.54; CI [0.57, 2.509]; p = 0.004), IL-8 (0.93; CI [0.116, 1.747]; p = 0.001) and IL-10 (2.55; CI [1.135, 3.97]; p = 0.004) in patients with severe COVID-19 than in patients with mild COVID-19.
Conclusions: Determination of the level of immunological markers, as CD3+, CD3+CD4+, CD3+CD8+ T-lymphocytes, CD16+CD56+ natural killers, CD19+ B-lymphocytes, C1q and C3 components of complement and IL-6, IL-8 and IL-10 can be used as early predictors of severe COVID-19.

References

Clinical characteristics of coronavirus disease 2019 in China / W.-J. Guan, Z.-Y. Ni, Y. Hu, [et al.] // NEJM. – 2020. – Vol. 382.- P. 1708–1720.

Severe COVID-19 is marked by a dysregulated myeloid cell compartment / J. Schulte-Schrepping, N. Reusch, D. Paclik, [et al.] // Cell. – 2020. – Vol. 182. – P. 1419–1440.

Acute SARS-CoV-2 infection impairs dendritic cell and T cell responses / R. Zhou, K.K.-W. To, Y.-C. Wong, [et al.] // Immunity. – 2020. – Vol. 53. – P. 864–877.

Троцько С.М. Лабораторные маркеры при диагностике тяжелого течения COVID-19: мета-анализ / С.М. Троцько, Т.В. Мамонтова // Проблемы и перспективы развития современной медицины. – 2021. – Т. 7. – С. 163-165.

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China / C. Huang, Y. Wang, X. Li, [et al.] // Lancet. – 2020. – Vol. 395. – P. 497–506.

Comprehensive mapping of immune perturbations associated with severe COVID-19 / L. Kuri-Cervantes, M. B. Pampena, W. Meng, [et al.] // Sci. Immunol. – 2020. – 5(49). – eabd7114.

Deep immune profiling of COVID-19 patients reveals distinct immunotypes with therapeutic implications / D. Mathew, J. R. Giles, A.E. Baxter, [et al.] // Science. – 2020. – Vol. 369: eabc8511.

Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-19 patients / H.-Y. Zheng, M. Zhang, C.-X. Yang, [et al.] // Cell Mol. Immunol. – 2020. – Vol. 17. – P. 541–543.

Functional exhaustion of antiviral lymphocytes in COVID-19 patients / M. Zheng, Y. Gao, G. Wang, [et al.] // Cell Mol. Immunol. – 2020. – Vol. 17. – P. 533–535.

Targets of T Cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals / A. Grifoni, D. Weiskopf, S. I. Ramirez, [et al.] // Cell. – 2020. – Vol. 181. – P. 1489–1501.

Phenotype and kinetics of SARS-CoV-2-specific T cells in COVID-19 patients with acute respiratory distress syndrome / D. Weiskopf, K.S. Schmitz, M.P. Raadsen, [et al.] // Sci. Immunol. – 2020. – Vol. 5. – P. eabd2071.

Clinical characteristics and immune injury mechanisms in 71 patients with COVID-19 / Y. Wu, X. Huang, J. Sun, [et al.] // mSphere. – 2020. – Vol. 5. – P. -e00362-20.

Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China / C. Qin, L. Zhou, Z. Hu, [et al.] // Clin. Infect. Dis. – 2020. – Vol. 71(15). – P. 762-768.

Changes of hematological and immunological parameters in COVID‑19 patients / X. Yuan, W. Huang, B. Ye, [et al.] // Int. J. Hematol. – 2020. – Vol. 112(4). – P. 553-559.

Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients / J. Liu, S. Li, J. Liu, [et al.] // EBioMedicine. – 2020. – Vol. 55. – P. 102763.

Clinical and pathological investigation of patients with severe COVID-19 / S. Li, L. Jiang, X. Li, [et al.] // JCI Insight. – 2020. – P. 5(12). – P. e138070.

Major reduction of NKT cells in patients with severe COVID-19 pneumonia / M.A. Zingaropoli, V. Perri, P. Pasculli, [et al.] // Clin. Immunol. – 2021. – Vol. 222. – P. 108630.

Dynamic changes in lymphocyte subsets and parallel cytokine levels in patients with severe and critical COVID-19 / Y. Liu, W. Tan, H. Chen, [et al.] // BMC Infect. Dis. – 2021. – Vol. 21. – P. 79-89.

Potential factors for prediction of disease severity of COVID-19 patients / H. Zhang, X. Wang, Z. Fu, [et al.] // medRxiv. – 2020.03.20.20039818; doi: https://doi.org/10.1101/2020.03.20.20039818

Clinical characteristics and risk factors of patients with severe COVID-19 in Jiangsu province, China: a retrospective multicentre cohort study / S. Liu, H. Luo, Y. Wang, [et al.] // BMC Infect. Dis. – 2020. – Vol. 20(1). – P. 584.

The characterization of disease severity associated IgG subclasses response in COVID-19 patients / H. Luo, T. Jia, J. Chen, [et al.] // Front. Immunol. – 2021. – Vol. 12. – P. 632814.

Aberrant cytokine expression in COVID-19 patients: Associations between cytokines and disease severity / Y. Tang, J. Sun, H. Pan, [et al.] // Cytokine. – 2021. – Vol. 143. – P. 155523.

Relationships among lymphocyte subsets, cytokines, and the pulmonary inflammation index in coronavirus (COVID-19) infected patients / S. Wan, Q. Yi, S. Fan, [et al.] // Br. J. Haematol. – 2020. – Vol. 189. – P. 428–437.

Correlation between the variables collected at admission and progression to severe cases during hospitalization among patients with COVID-19 in Chongqing / J. Duan, X. Wang, J. Chi, [et al.] // J. Med. Virol. – 2020. – Vol. 92(11). – P. 2616-2622.

Severe SARS-CoV-2 patients develop a higher specific T-cell response / J. Demaret, G. Lefèvre, F. Vuotto, [et al.]; Lille Covid Research Network (LICORNE) // Clin. Transl. Immunology. – 2020. – Vol. 9(12). – P. e1217.

Viral loads, lymphocyte subsets and cytokines in asymptomatic, mildly and critical symptomatic patients with SARS-CoV-2 infection: a retrospective study / S.W. Yin, Z. Zhou, J.L. Wang, [et al.] // Virol. J. – 2021. – Vol. 18(1). – P. 126.

Profiling of immune dysfunction in COVID-19 patients allows early prediction of disease progression / A.F. Rendeiro, J. Casano, C.K. Vorkas, [et al.] // Life Sci. Alliance. – 2020. –Vol. 4(2). – P. e202000955.

Sex differences in immune responses to SARS-CoV-2 that underlie disease outcomes / T. Takahashi, P. Wong, M.K. Ellingson, [et al.]; Yale IMPACT research team // Nature. – 2020. – Vol. 588(7837). – P. 315-320.

Published
2022-05-31
How to Cite
Mamontova, T. (2022). DIAGNOSIS AND PROGNOSIS SIGNIFICANCE OF IMMUNOLOGICAL MARKERS IN MIDDLE AND SEVERE COVID-19: META-ANALYSIS. Immunology and Allergy: Science and Practice, (4), 39-45. https://doi.org/10.37321/immunology.2021.4-04