Immune Phenotyping Based on the Neutrophil-to-Lymphocyte Ratio and IgG Level Predicts Disease Severity and Outcome for Patients With COVID-19

  1. Bicheng Zhang
  2. Xiaoyang Zhou
  3. Chengliang Zhu
  4. Yuxiao Song
  5. Fan Feng
  6. Yanru Qiu
  7. Jia Feng
  8. Qingzhu Jia
  9. Qibin Song
  10. Bo Zhu
  11. Jun Wang

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Abstract

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  1. Version published to 10.3389/fmolb.2020.00157
  2. ScreenIT

    SciScore for 10.1101/2020.03.12.20035048: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study received approval from the Research Ethics Committee of the Renmin Hospital of Wuhan University, Wuhan, China (approval number: WDRY2020-K094).
    Consent: The Research Ethics Committee waived the requirement informed consent before the study started because of the urgent need to collect epidemiological and clinical data.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    We retrospectively evaluated their anti-SARS-CoV-2 antibody response, clinical disease severity, and clinical outcome.
    anti-SARS-CoV-2
    suggested: None
    Antibody and cytokine assay: Anti-IgG and anti-IgM antibodies were detected using Human SARS-CoV-2 IgG and IgM Chemiluminescence Analysis (CLIA) Assays panel (Shenzhen YHLO Biotech Co.,Ltd., Shenzhen, China) and the high-speed CLIA system iFlash 3000 (Shenzhen YHLO Biotech Co.,Ltd., Shenzhen, China).
    Anti-IgG
    suggested: None
    anti-IgM
    suggested: None
    Human SARS-CoV-2 IgG
    suggested: None
    Software and Algorithms
    SentencesResources
    Proinflammatory cytokines including interleukin (IL)-2, IL-4, IL-6, IL-10, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α) were detected using Human Cytokine Standard Assays panel (ET Healthcare, Inc., Shanghai, China) and the Bio-Plex 200 system (Bio-Rad, Hercules, CA, USA) according to the manufacturer’s instructions.
    ET Healthcare
    suggested: None
    Statistical analyses in this study were performed with use of STATA 15.0 software (Stata Corporation, College Station, TX, USA).
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our retrospective investigation had some limitations. Firstly, virus titers were not monitored during SARS-CoV-2 infection and patient recovery. Higher IgG levels, however, were previously detected in patients who had negative pre-discharge fecal RT-PCR results and SARS-CoV-infected rhesus macaques that had markedly reducing virus titers.7 Secondly, it is unknown whether the change or increase of IgM or IgA is related to disease severity. The mechanism responsible for the immunopathologic reaction of IgG remains elusive. Finally, the IgG response and its correlation to the severity of COVID-19 in patients without high-dose corticosteroid intervention have not been addressed. Nevertheless, our findings indicate that severe COVID-19 was associated with a more robust IgG response that can be developed as an acquired immunity-related marker to predictive disease severity, along with other innate immunity-relate makers such as NLR. Further study on the immunopathogenesis of SARS-CoV-2 infection is warranted.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.03.12.20035048 on medRxiv