Immune profiles to distinguish hospitalized versus ambulatory COVID-19 cases in older patients
Jéromine Klingler,
Gregory S. Lambert,
Juan C. Bandres,
Rozita Emami-Gorizi,
Arthur Nádas,
Kasopefoluwa Y. Oguntuyo,
Fatima Amanat,
Maria C. Bermúdez-González,
Charles Gleason,
Giulio Kleiner,
Viviana Simon,
Benhur Lee,
Susan Zolla-Pazner,
Chitra Upadhyay,
Catarina E. Hioe
Affiliations
Jéromine Klingler
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters VA Medical Center, Bronx, NY, USA
Gregory S. Lambert
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Juan C. Bandres
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters VA Medical Center, Bronx, NY, USA
Rozita Emami-Gorizi
James J. Peters VA Medical Center, Bronx, NY, USA
Arthur Nádas
Department of Environment Medicine, NYU School of Medicine, New York, NY, USA
Kasopefoluwa Y. Oguntuyo
Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Fatima Amanat
Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Maria C. Bermúdez-González
Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Vaccine Research and Pandemic Preparedness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Charles Gleason
Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Vaccine Research and Pandemic Preparedness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Giulio Kleiner
Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Vaccine Research and Pandemic Preparedness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Viviana Simon
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Vaccine Research and Pandemic Preparedness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Benhur Lee
Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Susan Zolla-Pazner
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Chitra Upadhyay
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Catarina E. Hioe
Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters VA Medical Center, Bronx, NY, USA; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Corresponding author
Summary: A fraction of patients with COVID-19 develops severe disease requiring hospitalization, while the majority, including high-risk individuals, experience mild symptoms. Severe disease has been associated with higher levels of antibodies and inflammatory cytokines but often among patients with diverse demographics and comorbidity status.This study evaluated hospitalized vs. ambulatory patients with COVID-19 with demographic risk factors for severe COVID-19: median age of 63, >80% male, and >85% black and/or Hispanic. Sera were collected four to 243 days after symptom onset and evaluated for binding and functional antibodies as well as 48 cytokines and chemokines.SARS-CoV-2-specific antibody levels and functions were similar in ambulatory and hospitalized patients. However, a strong correlation between anti-S2 antibody levels and the other antibody parameters, along with higher IL-27 levels, was observed in hospitalized but not ambulatory cases. These data indicate that antibodies against the relatively conserved S2 spike subunit and immunoregulatory cytokines such as IL-27 are potential immune determinants of COVID-19.
