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

Carissimo, G.; Xu, W.; Kwok, I.; Abdad, M. Y.; Chan, Y. H.; Fong, S. W.; Puan, K. J.; Lee, C. Y. P.; Yeo, N. K.-W.; Amrun, S. N.; Chee, R. S.-L.; How, W.; Chan, S.; Fan, E. B.; Andiappan, A.; Lee, B.; Rotzschke, O.; Young, B. E.; Leo, Y.-S.; Lye, D. C.; Renia, L.; Ng, L. G.; Larbi, A.; Ng, L. F.

doi:10.1101/2020.06.11.147389

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bioRxiv · 10.1101/2020.06.11.147389

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

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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 revealed a dramatic increase in the number of immature neutrophils. This increase strongly correlated with disease severity and was associated with elevated IL-6 and IP-10 levels, two key players in the cytokine storm. The most pronounced decrease in cell counts was observed for CD8 T-cells and VD2 {gamma}{delta} T-cells, which both exhibited increased differentiation and activation. ROC analysis revealed that the count ratio of immature neutrophils to CD8 or VD2 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.

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Carissimo, G., Xu, W., Kwok, I., Abdad, M. Y., Chan, Y. H., Fong, S. W., Puan, K. J., Lee, C. Y. P., Yeo, N. K.-W., Amrun, S. N., Chee, R. S.-L., How, W., Chan, S., Fan, E. B., Andiappan, A., Lee, B., Rotzschke, O., Young, B. E., Leo, Y.-S., Lye, D. C., Renia, L., Ng, L. G., Larbi, A., Ng, L. F.. 2020-06-12. Whole blood immunophenotyping uncovers immature neutrophil-to-VD2 T-cell ratio as an early prognostic marker for severe COVID-19. https://doi.org/10.1101/2020.06.11.147389

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