Peripheral blood immune status at clinical onset correlates with severity of Coronavirus Disease 2019

  1. Nathalie Santoro
  2. Alessandro Cignetti
  3. Valerio Tenace
  4. Ines Clotilde Casonato
  5. Domenico Cosseddu
  6. Margherita Vizzini
  7. Giovanni De Rosa
  8. Massimo Geuna

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Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic is a global threat to healthcare systems, requiring hospitalization in sub intensive and intensive care for respiratory syndrome in 25-30% of patients and accounting for a lethality up to 15%.

In this retrospective study the clinical characteristics of 215 COVID-19 patients were correlated with the peripheral blood immune status.

Different groups of COVID-19 patients may be identified on the basis of clinical behavior and a strong correlation between groups and age and comorbidities as well as with the immune profile is demonstrated. A lower age correlates with a lower severity of the disease differentiating between patients who may be quarantined at home and those requiring hospitalization. An older age (>82 years) together with a higher number of comorbidities is associated to a very severe prognosis. The absolute number of CD3+, CD4+, CD8+ T lymphocytes was progressively decreasing according to the severity of the disease and a CD3+ and CD8+ threshold indicating very severe cases is suggested.

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  1. ScreenIT

    SciScore for 10.1101/2020.06.03.20116533: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: All patients authorized data disclosure by signing an informed consent form at admission.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Briefly, 50 μl of peripheral blood, collected in EDTA containing tubes, were stained with a mixture of monoclonal antibodies (CD45 KO, HLA-DR PB, CD8 FITC, CD16+CD56 PE, CD19 PC7
    CD19
    suggested: None
    Software and Algorithms
    SentencesResources
    Throat swab samples were obtained from patients and processed with RT-PCR method by means of the diagnostic GeneFinder
    GeneFinder
    suggested: (GENEFINDER, RRID:SCR_009190)
    The XLstat software was used for the statistical analysis (ANOVA, T test), data modelling and graphical representation (box and whiskers plots).
    XLstat
    suggested: (XLSTAT, RRID:SCR_016299)

    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:
    The present study has some limitations. First of all, we only evaluated the main lymphocyte populations without investigating T cell subsets or cytokine production. Secondly, it is a retrospective study that does not take into account second or third immunophenotypic analysis of the same patients and the obvious evolution of the immune profile. Similarly, the follow up of the patients is limited to a short period of time, and consequently the group to which they are belonging reflects a “frozen” situation. On the other hand, the purpose of the present study was not to evaluate the clinical course of the disease but to identify one or more early indicators of the clinical course, focusing on clinical and laboratory features at diagnosis. In conclusion, the immune profiling associated to age and comorbidities may help identifying different groups of COVID-19 patients with different clinical behavior. Further studies are needed to identify laboratory parameters correlated with the clinical course and to create a scoring system that will rapidly guide therapy and clinical management.

    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.

  2. Version published to 10.1101/2020.06.03.20116533v1 on medRxiv