Immune cell kinetics and antibody response in COVID‐19 patients with low‐count monoclonal B‐cell lymphocytosis

• Published in: American journal of hematology Vol. 98; no. 12; pp. 1909 - 1922
• Main Authors: Oliva‐Ariza, Guillermo, Fuentes‐Herrero, Blanca, Lecrevisse, Quentin, Carbonell, Cristina, Pérez‐Pons, Alba, Torres‐Valle, Alba, Pozo, Julio, Martín‐Oterino, José Ángel, González‐López, Óscar, López‐Bernús, Amparo, Bernal‐Ribes, Marta, Belhassen‐García, Moncef, Pérez‐Escurza, Oihane, Pérez‐Andrés, Martín, Vazquez, Lourdes, Hernández‐Pérez, Guillermo, García Palomo, Francisco Javier, Leoz, Pilar, Costa‐Alba, Pilar, Pérez‐Losada, Elena, Yeguas, Ana, Santos Sánchez, Miryam, García‐Blázquez, Marta, Morán‐Plata, F. Javier, Damasceno, Daniela, Botafogo, Vitor, Muñoz‐García, Noemí, Fluxa, Rafael, Dongen, Jacques J. M., Marcos, Miguel, Almeida, Julia, Orfao, Alberto
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.12.2023; Wiley Subscription Services, Inc
• Subjects: Antibodies; Antibody response; Blood; COVID-19; Dendritic cells; Enzyme-linked immunosorbent assay; Flow cytometry; Hematology; Immune response (humoral); Immunodeficiency; Infections; Leukocytes (basophilic); Leukocytes (eosinophilic); Leukocytes (neutrophilic); Lymphocytes; Lymphocytosis; Monocytes; Neutrophils; Plasma levels; Risk factors; Severe acute respiratory syndrome coronavirus 2
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.27119

Low‐count monoclonal B‐cell lymphocytosis (MBLlo) has been associated with an underlying immunodeficiency and has recently emerged as a new risk factor for severe COVID‐19. Here, we investigated the kinetics of immune cell and antibody responses in blood during COVID‐19 of MBLlo versus non‐MBL patients. For this study, we analyzed the kinetics of immune cells in blood of 336 COVID‐19 patients (74 MBLlo and 262 non‐MBL), who had not been vaccinated against SARS‐CoV‐2, over a period of 43 weeks since the onset of infection, using high‐sensitivity flow cytometry. Plasma levels of anti‐SARS‐CoV‐2 antibodies were measured in parallel by ELISA. Overall, early after the onset of symptoms, MBLlo COVID‐19 patients showed increased neutrophil, monocyte, and particularly, plasma cell (PC) counts, whereas eosinophil, dendritic cell, basophil, and lymphocyte counts were markedly decreased in blood of a variable percentage of samples, and with a tendency toward normal levels from week +5 of infection onward. Compared with non‐MBL patients, MBLlo COVID‐19 patients presented higher neutrophil counts, together with decreased pre‐GC B‐cell, dendritic cell, and innate‐like T‐cell counts. Higher PC levels, together with a delayed PC peak and greater plasma levels of anti‐SARS‐CoV‐2‐specific antibodies (at week +2 to week +4) were also observed in MBLlo patients. In summary, MBLlo COVID‐19 patients share immune profiles previously described for patients with severe SARS‐CoV‐2 infection, associated with a delayed but more pronounced PC and antibody humoral response once compared with non‐MBL patients.