Cellular and humoral immunity in patients infected with the SARS-CoV-2 virus at general hospital

Brandão, Valéria; Saito, Thaís T.; Guterres, Débora S.; Lima, Grasiele; Tencarte, Sara; Dos Santos, Ana Carolina; Laubi, Marina; Lourenço, Roselene; Grecco, Octavio; Toledo Barros, Myrthes; Barros, Myrthes T.; Kokron, Cristina; Marinho, Ana Karolina

Rationale: The cellular immune response seems to have a central role in the pathophysiology of COVID-19. Few studies have analyzed lymphocyte subpopulations and clinical outcomes. We evaluated clinical and immunological characteristics of patients infected with the SARS-CoV-2 virus and described the outcomes during hospitalization. Method(s): Prospective and descriptive study carried with adult patients, admitted with a diagnosis of COVID-19 confirmed by RT-PCR. We evaluated lymphocytes subsets (CD3+, CD4+, CD8+, CD19), serum immunoglobulin levels (IgG, IgM, IgA) and described the mean hospital stay outcomes, need for intensive care, mechanical ventilation and death. Result(s): Of the 165 patients included, 65% were male, with an average of 58.7 years. The most related initial symptoms were dyspnea (80%), fever (74%) and cough (70%). Among the reported comorbidities, 58% had obesity, 47% systemic arterial hypertension and 25% diabetes. We observed that 40% lymphopenia, 43% reduction in CD3+, 46% reduction in CD4+, 50% reduction in CD8+ and 39% reduction in CD19+. The average levels of IgG, IgM and IgA were 1,285, 121 and 296mg / dL, respectively. We identified 3 patients with selective IgA deficiency and all were discharged. Regarding the outcome, 28% required intensive care unit, 24% mechanical ventilation conditions and 23% of the patients died. Conclusion(s): Lymphopenia, reduction of CD8+, CD4+ and CD3+ cells were frequent in hospitalized patients, inferring greater clinical severity. However, we identified three patients with selective IgA deficiency whose outcome was hospital discharge.Copyright © 2020