Association of Early Nasopharyngeal Immune Markers With COVID-19 Clinical Outcome: Predictive Value of CCL2/MCP-1

Abstract

Early recognition of severe forms of coronavirus disease 2019 (COVID-19) is essential for an opportune and effective intervention, reducing life-risking complications. An altered inflammatory immune response seems to be associated with COVID-19's pathogenesis and progression to severity. Here we demonstrate the utility of early nasopharyngeal swab samples for detection of the early expression of immune markers and the potential value of CCL2/MCP-1 in predicting disease outcome.

Keywords: COVID-19; chemokines; cytokines; inflammation; prognostic biomarkers.

Figure 1.

Relative gene expression of immune mediators in nasopharyngeal swab samples from coronavirus disease 2019 cases and controls. A, Expression of TNFα transcripts in different study groups of subjects: controls (samples from 16 healthy individuals confirmed as negative for severe acute respiratory syndrome coronavirus 2); favorable (23 subjects with favorable evolution: 12 asymptomatic subjects and 11 patients with mild disease); unfavorable (15 patients with unfavorable evolution: 9 very symptomatic patients and 6 who required intensive care; of these 6, 3 recovered and 3 died). B, Expression of CCL2/MCP-1 transcripts in those 3 groups. C, Expression of CCL3/MIP-1α transcripts in the 3 groups. D, Expression of TGFβ transcripts in the 3 groups. mRNA was determined for real-time reverse transcription polymerase chain reaction analysis, and the genes/housekeeping gene ratio was determined according to the delta/delta Ct method. Data are shown as dot plot graphics, on a log scale. Each dot plot shows statistic data about the gene expression determination. The central horizontal line in the dot marks the median of the samples; the hinges mark the ranges. Statistically significant differences in cytokine production among groups are indicated with horizontal lines over the dots. A P < .05 was considered statistically significant. P > .05 was considered not statistically significant. *P < .05; ^**P < .01; ^***P < .001.