Some Clinical and Immunological Features of Imported COVID-19 Cases in Mongolia

Sandag, T.; Lkhagvasuren, E.; Batmunkh, M.; Ravjir, O.

SARS-CoV-2 disturbs the normal immune responses causing an uncontrolled inflammatory response in patients with severe COVID-19. The pattern of the immune response to the SARS-CoV-2 in individuals may fluctuate. Some have a virus-dependent protective immune response resulting in asymptomatic or mild disease with elimination of the virus within 7-10 days after onset of infection. Others develop virus non-dependent uncontrolled hyper-inflammation in the later period, leading to severe disease with cytokine storm, acute respiratory distress syndrome, disseminated intravascular coagulation and multi-organ failure. Methods: The serum of 72 patients was investigated for titers of 15 cytokines and chemokines using Enzyme-linked immunosorbent assay (ELISA) kits in the serum of peripheral blood samples. The means of groups were compared using ANOVA followed by Tukey multiple post hoc comparisons if the ANOVA p-value was <0.05. Results: Patients with pulmonary infiltrates on CT demonstrated a lower percentage of eosinophils (1.38{+/-}1.46%) and elevated level of serum CRP (8.57{+/-}19.10 mg/dL) compared to patients without pulmonary infiltrates (2.52{+/-}1.47% and 1.96{+/-}3.02 mg/dL respectively; p<0.05). ROC analysis for patients aged [≥]35 years showed patients with mild disease (n=3) had a significantly higher titer of IL-1 and MCP-1 (AUC, 0.958 and 0.917 respectively, p<0.05) compared to patients with moderate disease (n=7).