Detalle Publicación


Immunological biomarkers of fatal COVID-19: a study of 868 patients

Autores: Martín-Sánchez, E. ; Garcés, J. J.; Maia, C.; Inoges Sancho, Susana Inmaculada; López Díaz de Cerio, Ascensión; Carmona-Torre, F.; Marín-Oto, M.; Alegre Garrido, Félix; Molano, E.; Fernández-Alonso, M.; Pérez, C.; Botta, C.; Zabaleta, A.; Alcaide, A. B.; Landecho Acha, Manuel Fortún; Rua, M.; Pérez-Wamisher, T.; Blanco, L.; Sarvide, S.; Vilas Zornoza, Amaia; Alignani, D.; Moreno, C.; Pineda, I.; Sogbe, M.; Argemí Ballbé, José María; Paiva, Bruno; Yuste Ara, José Ramón (Autor de correspondencia)
Título de la revista: FRONTIERS IN IMMUNOLOGY
ISSN: 1664-3224
Volumen: 12
Páginas: 659018
Fecha de publicación: 2021
Information on the immunopathobiology of coronavirus disease 2019 (COVID-19) is rapidly increasing; however, there remains a need to identify immune features predictive of fatal outcome. This large-scale study characterized immune responses to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection using multidimensional flow cytometry, with the aim of identifying high-risk immune biomarkers. Holistic and unbiased analyses of 17 immune cell-types were conducted on 1,075 peripheral blood samples obtained from 868 COVID-19 patients and on samples from 24 patients presenting with non-SARS-CoV-2 infections and 36 healthy donors. Immune profiles of COVID-19 patients were significantly different from those of age-matched healthy donors but generally similar to those of patients with non-SARS-CoV-2 infections. Unsupervised clustering analysis revealed three immunotypes during SARS-CoV-2 infection; immunotype 1 (14% of patients) was characterized by significantly lower percentages of all immune cell-types except neutrophils and circulating plasma cells, and was significantly associated with severe disease. Reduced B-cell percentage was most strongly associated with risk of death. On multivariate analysis incorporating age and comorbidities, B-cell and non-classical monocyte percentages were independent prognostic factors for survival in training (n=513) and validation (n=355) cohorts. Therefore, reduced percentages of B-cells and non-classical monocytes are high-risk immune biomarkers for risk-stratification of COVID-19 patients.