| Autor: |
Gil-Etayo FJ; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Garcinuño S; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Utrero-Rico A; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Cabrera-Marante O; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Arroyo-Sanchez D; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Mancebo E; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Pleguezuelo DE; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Rodríguez-Frías E; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Allende LM; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain.; Department of Immunology, Ophthalmology and Otorhinolaryngology, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain., Morales-Pérez P; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Castro-Panete MJ; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain., Lalueza A; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain.; Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain., Lumbreras C; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain.; Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain., Paz-Artal E; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain.; Department of Immunology, Ophthalmology and Otorhinolaryngology, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain., Serrano A; Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain.; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. |
| Abstrakt: |
The Th1/Th2 balance plays a crucial role in the progression of different pathologies and is a determining factor in the evolution of infectious diseases. This work has aimed to evaluate the early, or on diagnosis, T-cell compartment response, T-helper subsets and anti-SARS-CoV-2 antibody specificity in COVID-19 patients and to classify them according to evolution based on infection severity. A unicenter, randomized group of 146 COVID-19 patients was divided into four groups in accordance with the most critical events during the course of disease. The immunophenotype and T-helper subsets were analyzed by flow cytometry. Asymptomatic SARS-CoV-2 infected individuals showed a potent and robust Th1 immunity, with a lower Th17 and less activated T-cells at the time of sample acquisition compared not only with symptomatic patients, but also with healthy controls. Conversely, severe COVID-19 patients presented with Th17-skewed immunity, fewer Th1 responses and more activated T-cells. The multivariate analysis of the immunological and inflammatory parameters, together with the comorbidities, showed that the Th1 response was an independent protective factor for the prevention of hospitalization (OR 0.17, 95% CI 0.03-0.81), with an AUC of 0.844. Likewise, the Th1 response was found to be an independent protective factor for severe forms of the disease (OR 0.09, 95% CI: 0.01-0.63, p = 0.015, AUC: 0.873). In conclusion, a predominant Th1 immune response in the acute phase of the SARS-CoV-2 infection could be used as a tool to identify patients who might have a good disease evolution. |
