Increased B-cell activity with consumption of activated monocytes in severe COVID-19 patients |
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| Authors: | Igor Kos Benedikt Balensiefer Vadim Lesan Dominic Kaddu-Mulindwa Lorenz Thurner Konstantin Christofyllakis Joerg Thomas Bittenbring Manfred Ahlgrimm Martina Seiffert Stefan Wagenpfeil Yvonne Bewarder Frank Neumann Torben Rixecker Sigrun Smola Andreas Link Marcin Krawczyk Frank Lammert Philipp M Lepper Robert Bals Stephan Stilgenbauer Moritz Bewarder |
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| Institution: | 1. Internal Medicine I, Saarland University Medical Center, Homburg, Germany;2. Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany;3. Institute for Medical Biometrics, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany;4. Department of Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany;5. Department of Pulmonology, Allergology and Critical Care Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany;6. Institute of Virology, Saarland University Medical Center, Homburg/Saar, Germany;7. Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany;8. Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
Hannover Medical School, Hannover, Germany |
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| Abstract: | The pathogenesis of autoimmune complications triggered by SARS-CoV2 has not been completely elucidated. Here, we performed an analysis of the cellular immune status, cell ratios, and monocyte populations of patients with COVID-19 treated in the intensive care unit (ICU) (cohort 1, N = 23) and normal care unit (NCU) (cohort 2, n = 10) compared with control groups: patients treated in ICU for noninfectious reasons (cohort 3, n = 30) and patients treated in NCU for infections other than COVID-19 (cohort 4, n = 21). Patients in cohort 1 presented significant differences in comparison with the other cohorts, including reduced frequencies of lymphocytes, reduced CD8+T-cell count, reduced percentage of activated and intermediate monocytes and an increased B/T8 cell ratio. Over time, patients in cohort 1 who died presented with lower counts of B, T, CD4+T, CD8+T-lymphocytes, NK cells, and activated monocytes. The B/T8 ratio was significantly lower in the group of survivors. In cohort 1, significantly higher levels of IgG1 and IgG3 were found, whereas cohort 3 presented higher levels of IgG3 compared to controls. Among many immune changes, an elevated B/T8-cell ratio and a reduced rate of activated monocytes were mainly observed in patients with severe COVID-19. Both parameters were associated with death in cohort 1. |
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| Keywords: | Autoimmunity ⋅ B/T-cell ratio ⋅ COVID-19 ⋅ Lymphocytes ⋅ Monocytes |
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