Immune profiles to distinguish hospitalized versus ambulatory COVID-19 cases in older patients.

A fraction of patients with COVID-19 develops severe disease requiring hospitalization, while the majority, including high-risk individuals, experience mild symptoms. Severe disease has been associated with higher levels of antibodies and inflammatory cytokines but often among patients with diverse demographics and comorbidity status. This study evaluated hospitalized vs. ambulatory patients with COVID-19 with demographic risk factors for severe COVID-19: median age of 63, >80% male, and >85% black and/or Hispanic. Sera were collected four to 243 days after symptom onset and evaluated for binding and functional antibodies as well as 48 cytokines and chemokines. SARS-CoV-2-specific antibody levels and functions were similar in ambulatory and hospitalized patients. However, a strong correlation between anti-S2 antibody levels and the other antibody parameters, along with higher IL-27 levels, was observed in hospitalized but not ambulatory cases. These data indicate that antibodies against the relatively conserved S2 spike subunit and immunoregulatory cytokines such as IL-27 are potential immune determinants of COVID-19. Comparable SARS-CoV-2 Ab profiles of hospitalized and ambulatory cases Concordance of Ab responses to spike S2 vs. S1 subunits only in hospitalized cases High levels of serum IL-27 after convalescence in hospitalized patients Health sciences; Population; Immunology; Immune response

一部分新冠病毒（COVID - 19）患者会发展为需要住院治疗的重症，而包括高危个体在内的大多数患者则症状较轻。重症与较高水平的抗体和炎性细胞因子有关，但通常出现在不同人口统计学特征和合并症状况的患者中。 本研究评估了具有新冠重症人口统计学风险因素的住院患者和非住院患者：中位年龄为63岁，男性占80%以上，黑人和/或西班牙裔占85%以上。在症状出现后4到243天收集血清，并对结合抗体和功能性抗体以及48种细胞因子和趋化因子进行评估。 在非住院患者和住院患者中，新冠病毒特异性抗体水平和功能相似。然而，在住院患者（而非非住院患者）中观察到抗S2抗体水平与其他抗体参数之间存在强相关性，同时白细胞介素 - 27（IL - 27）水平较高。这些数据表明，针对相对保守的S2刺突亚单位的抗体以及诸如IL - 27等免疫调节细胞因子是新冠病毒的潜在免疫决定因素。 住院患者和非住院患者具有相似的新冠病毒抗体谱 仅在住院患者中刺突S2与S1亚单位抗体反应的一致性 住院患者康复后血清IL - 27水平较高 健康科学；人群；免疫学；免疫反应