Whole blood immunophenotyping uncovers immature neutrophil-to-VD2 T-cell ratio as an early marker for severe COVID-19

Nat Commun. 2020 Oct 16;11(1):5243. doi: 10.1038/s41467-020-19080-6.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Betacoronavirus / immunology*
  • Biomarkers / blood
  • CD8-Positive T-Lymphocytes / immunology*
  • COVID-19
  • Coronavirus Infections / immunology
  • Coronavirus Infections / pathology
  • Cytokine Release Syndrome / immunology
  • Cytokine Release Syndrome / pathology
  • Flow Cytometry
  • Humans
  • Immunophenotyping / methods
  • Interleukin-10 / blood
  • Interleukin-6 / blood
  • Lymphocyte Count
  • Neutrophils / immunology*
  • Pandemics
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / pathology
  • Receptors, Antigen, T-Cell, gamma-delta / immunology*
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Biomarkers
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-6
  • Receptors, Antigen, T-Cell, gamma-delta
  • Interleukin-10