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. 2022 Mar 15;225(6):977-982.
doi: 10.1093/infdis/jiab604.

High SARS-CoV-2 Viral Load and Low CCL5 Expression Levels in the Upper Respiratory Tract Are Associated With COVID-19 Severity

Felipe Pérez-García  1   2   3 , María Martin-Vicente  1   4 , Rosa Lía Rojas-García  1 , Lucía Castilla-García  5 , María José Muñoz-Gomez  1 , Irene Hervás Fernández  2 , Victoria González Ventosa  2 , Erick Joan Vidal-Alcántara  1 , Juan Cuadros-González  2   3 , Jesús F Bermejo-Martin  6   7   8 , Salvador Resino  1   4 , Isidoro Martínez  1   4
Affiliations

High SARS-CoV-2 Viral Load and Low CCL5 Expression Levels in the Upper Respiratory Tract Are Associated With COVID-19 Severity

Felipe Pérez-García et al. J Infect Dis. .

Abstract

Mucosal immune response in the upper respiratory tract is crucial for initial control of viral replication, clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and progression of coronavirus disease 2019 (COVID-19). We analyzed SARS-CoV-2 RNA load and expression of selected immune genes in the upper respiratory tract (nasopharynx) of 255 SARS-CoV-2-infected patients and evaluated their association with severe COVID-19. SARS-CoV-2 replication in nasopharyngeal mucosa induces expression of several innate immune genes. High SARS-CoV-2 viral load and low CCL5 expression levels were associated with intensive care unit admission or death, although CCL5 was the best predictor of COVID-19 severity.

Keywords: CCL5; COVID-19; ICU; SARS-CoV-2; death; gene expression; innate immunity; nasopharynx; viral load.

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Figures

Graphical Abstract
Graphical Abstract
Figure 1.
Figure 1.
A–J, Relative expression of innate immunity genes and SARS-CoV-2 viral load in the upper respiratory tract of COVID-19 patients. Values are expressed as log2 (fold-changes) to the median of healthy controls to facilitate comparisons between groups. The differences between groups were assessed using the Mann-Whitney U test. Abbreviations: CCL5, chemokine (C-C motif) ligand 5; COVID-19, coronavirus disease 2019; CXCL10, C-X-C motif chemokine ligand 10; IFIT1, interferon-induced protein with tetratricopeptide repeats 1; IFN-β, interferon-β; IL-6, interleukin 6; IL-8, interleukin 8; ISG15, interferon-stimulated gene 15; RIGI, retinoic acid-inducible gene I; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TNF-α, tumor necrosis factor-α; VL, viral load.
Figure 2.
Figure 2.
A–C, Association between mucosal biomarkers (log2 values) in the upper respiratory tract and ICU admission or death during hospital admission. The association analysis was performed by logistic regression adjusted by the most significant covariables. Abbreviations: aOR, adjusted odds ratio; CCL5, chemokine (C-C motif) ligand 5; CI, confidence interval; ICU, intensive care unit; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; VL, viral load.
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