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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Viral Immunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1452638
This article is part of the Research Topic Enigma Unmasked: Deciphering the Humoral Immune Response in Long COVID View all articles

Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study

Provisionally accepted
Riccardo Giuseppe Margiotta Riccardo Giuseppe Margiotta 1Emanuela Sozio Emanuela Sozio 2Fabio Del Ben Fabio Del Ben 3,4*Antonio Paolo Beltrami Antonio Paolo Beltrami 3,4Daniela Cesselli Daniela Cesselli 3,4Martina Fabris Martina Fabris 3,4Francesco Curcio Francesco Curcio 3,4Carlo Tascini Carlo Tascini 2,3Guido Sanguinetti Guido Sanguinetti 1
  • 1 International School for Advanced Studies (SISSA), Trieste, Italy
  • 2 Infectious Disease Unit, Friuli Venezia Giulia University Hospital (ASU FC), Udine, Italy
  • 3 Department of Medicine, University of Udine, Udine, Italy
  • 4 Department of Laboratory Medicine, Friuli Venezia Giulia University Hospital (ASU FC), Udine, Italy

The final, formatted version of the article will be published soon.

    The COVID-19 pandemic has left an indelible mark globally, presenting numerous challenges to public health. This crisis, while disruptive and impactful, has provided a unique opportunity to gather precious clinical data extensively. In this observational, case-control study, we utilized data collected at the Azienda Sanitaria Universitaria Friuli Centrale, Italy, to comprehensively characterize the immuno-inflammatory features in COVID-19 patients. Specifically, we employed multicolor flow cytometry, cytokine assays, and inflammatory biomarkers to elucidate the interplay between the infectious agent and the host's immune status. We characterized immuno-inflammatory profiles within the first 72 hours of hospital admission, stratified by age, disease severity, and time elapsed since symptom onset.Our findings indicate that patients admitted to the hospital shortly after symptom onset exhibit a distinct pattern compared to those who arrive later, characterized by a more active immune response and heightened cytokine activity, but lower markers of tissue damage. We used univariate and multivariate logistic regression models to identify informative markers for outcome severity. Predictors incorporating the immuno-inflammatory features significantly outperformed standard baselines, identifying up to 59% of patients with positive outcomes while maintaining a false omission rate as low as 4%. Overall, our study sheds light on the immuno-inflammatory aspects observed in COVID-19 patients prior to vaccination, providing insights for guiding the clinical management of first-time infections by a novel virus.

    Keywords: COVID-19, Cytokines, immunology, Inflammation, Flow Cytometry, Immune System, predictive modelling

    Received: 21 Jun 2024; Accepted: 11 Nov 2024.

    Copyright: © 2024 Margiotta, Sozio, Del Ben, Beltrami, Cesselli, Fabris, Curcio, Tascini and Sanguinetti. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fabio Del Ben, Department of Medicine, University of Udine, Udine, Italy

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