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

By Guillaume Carissimo, Weili Xu, Immanuel Kwok, Mohammad Yazid Abdad, Yi-Hao Chan, Siew-Wai Fong, Kia Joo Puan, Cheryl Yi-Pin Lee, Nicholas Kim-Wah Yeo, Siti Naqiah Amrun, Rhonda Sin-Ling Chee, Wilson How, Stephrene Chan, Eugene Bingwen Fan, Anand Kumar Andiappan, Bernett Lee, Olaf Rötzschke, Barnaby Edward Young, Yee-Sin Leo, David C. Lye, Laurent Renia, Lai Guan Ng, Anis Larbi, Lisa FP Ng

Posted 12 Jun 2020
bioRxiv DOI: 10.1101/2020.06.11.147389 (published 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 revealed a dramatic increase in the number of immature neutrophils. This increase strongly correlated with disease severity and was associated with elevated IL-6 and IP-10 levels, two key players in the cytokine storm. The most pronounced decrease in cell counts was observed for CD8 T-cells and VD2 gd T-cells, which both exhibited increased differentiation and activation. ROC analysis revealed that the count ratio of immature neutrophils to CD8 or VD2 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. ### Competing Interest Statement The authors have declared no competing interest.

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