Immune profiles to distinguish hospitalized versus ambulatory COVID-19 cases in older patients—Klinger 2022

Most COVID-19 patients, especially high-risk ones, have minimal symptoms. Patients with various demographics and comorbidities have greater antibody and inflammatory cytokine levels in severe illness. Hospitalized and ambulatory COVID-19 patients with demographic risk indicators for severe disease—median age of 63, >80% male, and >85% black and/or Hispanic—were compared. Sera were tested for binding and functional antibodies and 48 cytokines and chemokines four to 243 days following symptom onset. Ambulatory and inpatient SARS-CoV-2-specific antibody levels and functions were similar. Hospitalized patients had a strong connection between anti-S2 antibody levels and other antibody parameters and higher IL-27 levels. Antibodies against the largely conserved S2 spike component and immunoregulatory cytokines like IL-27 may be immunological determinants of COVID-19.

Klingler, J., Lambert, G. S., Bandres, J. C., Emami-Gorizi, R., Nádas, A., Oguntuyo, K. Y., Amanat, F., Bermúdez-González, M. C., Gleason, C., Kleiner, G., Simon, V., Lee, B., Zolla-Pazner, S., Upadhyay, C., & Hioe, C. E. (2022). Immune profiles to distinguish hospitalized versus ambulatory COVID-19 cases in older patients. iScience, 25(12), 105608. https://doi.org/10.1016/j.isci.2022.105608