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

• Published in: Nature communications Vol. 11; no. 1; p. 5243
• Main Authors: Carissimo, Guillaume, Xu, Weili, Kwok, Immanuel, Abdad, Mohammad Yazid, Chan, Yi-Hao, Fong, Siew-Wai, Puan, Kia Joo, Lee, Cheryl Yi-Pin, Yeo, Nicholas Kim-Wah, Amrun, Siti Naqiah, Chee, Rhonda Sin-Ling, How, Wilson, Chan, Stephrene, Fan, Bingwen Eugene, Andiappan, Anand Kumar, Lee, Bernett, Rötzschke, Olaf, Young, Barnaby Edward, Leo, Yee-Sin, Lye, David Chien, Renia, Laurent, Ng, Lai Guan, Larbi, Anis, Ng, Lisa FP
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 16.10.2020; Nature Portfolio
• Subjects: 13/21; 13/31; 631/250/127; 631/250/2520; 631/250/255; 631/326/596/4130; Betacoronavirus - immunology; Biomarkers - blood; CD8-Positive T-Lymphocytes - immunology; Coronavirus Infections - immunology; Coronavirus Infections - pathology; COVID-19; Cytokine Release Syndrome - immunology; Cytokine Release Syndrome - pathology; Flow Cytometry; Humanities and Social Sciences; Humans; Immunophenotyping - methods; Interleukin-10 - blood; Interleukin-6 - blood; Lymphocyte Count; multidisciplinary; Neutrophils - immunology; Pandemics; Pneumonia, Viral - immunology; Pneumonia, Viral - pathology; Receptors, Antigen, T-Cell, gamma-delta - immunology; SARS-CoV-2; Science; Science (multidisciplinary); Severity of Illness Index
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-020-19080-6

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 reveals a dramatic increase in the number of immature neutrophils. This increase strongly correlates with disease severity and is associated with elevated IL-6 and IP-10 levels, two key players in the cytokine storm. The most pronounced decrease in cell counts is observed for CD8 T-cells and VD2 γδ T-cells, which both exhibit increased differentiation and activation. ROC analysis reveals that the count ratio of immature neutrophils to VD2 (or CD8) 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. COVID-19 severity is associated with cytokine levels and lymphopenia, but the role of immune cell subsets is not well understood. Here the authors immunophenotype whole blood samples from 54 COVID-19 patients and find that the immature neutrophil-to-VD2 T-cell ratio is associated with severe COVID-19.