Immune cell profiling and antibody responses in patients with COVID-19

BackgroundAlthough there are a growing number of studies on evaluating lymphocyte subset counts as prognostic factors for COVID-19 disease severity, the lymphocyte subsets' analyses of both IgM and IgG responders and non-responders during the periods after onset of symptoms, have not been conducted yet. So, this study aimed to evaluate immune cell profiling of COVID-19 patients with and without antibody responses.MethodsIn this cross-sectional study, the levels of peripheral lymphocyte subsets were measured using flow cytometry in 53 patients with positive SARS-CoV-2 RT-PCR, for whom antibody testing of COVID-19 was performed.ResultsThe white blood cell, neutrophil, and lymphocyte counts consistently decreased in the IgM and IgG non-responder group, while the differences in the median value between the two study groups were found to be statistically significant only in terms of neutrophil counts (P=0.024 for IgM response and p-value= 0.046 for IgG response, respectively). Moreover, the level of neutrophil-to-lymphocyte ratio was observed to be significantly lower in the IgM or IgG non-responder group compared to the IgM or IgG responder group (3.63.1 vs. 6.3 +/- 4.2; p-value= 0.021). The patients with IgM antibody response had a significantly lower CD20(+) lymphocytes (11% versus 15% in the groups without IgM antibody response, p-value= 0.031), The percentages of NK cells and CD4(+) T cells significantly increased in the patients with IgG antibody response compared to those without IgG antibody response (13% versus 10%, p-value= 0.028, and 41.5% versus 34%; p-value= 0.03, respectively). Moreover, the patients who produced IgM or IgG antibody had significantly higher percentages of total T lymphocytes (64% versus 54%; p-value= 0.017), CD4(+) T cells (41% versus 34%; p-value=0.038), and NK cells (13% versus 9%, p-value=0.023) compared to the group with no serological response. No significant difference was observed in the percentage of other lymphocyte subsets, including CD8(+) T cells, T-reg cells, and CD19(+) B cells.Conclusion Our results suggest that the total T cells, CD4(+) T cells, and NK cells percentages are linked to serological response. Moreover, our findings suggested that neutrophil absolute counts and neutrophil-to-lymphocyte ratio may be valuable predictors of IgM or IgG antibody response.