Patients with Covid-19 exhibit different immunological profiles according to their clinical presentation

OBJECTIVES

A novel beta coronavirus has been identified as responsible for the 2019 coronavirus infection (Covid-19). Clinical presentations range from asymptomatic cases to acute respiratory distress syndrome with fatal outcome. Such a broad spectrum of disease expression calls for an investigation of immune response characteristics.

METHODS

We identified subjects admitted for Covid-19 in whom a large panel of immunological markers were measured, including B- and T- and NK-lymphocyte phenotypes, T-lymphocyte subpopulation cells and plasma cytokines. Patients were divided according to symptom severity during hospitalisation, in those with uncomplicated and complicated infection. Differences between groups were analyzed.

RESULTS

Seventeen patients were included (mean age: 83 years; 9 women; mean delay of symptoms onset: 4 days). Six had uncomplicated infection, while 11 developed complicated forms during hospitalization. CD10 + B lymphocyte levels were inversely correlated with clinical severity (5.8% vs 2.0%, p = 0.04) and CD10+ levels above 3% were independently associated with uncomplicated forms [Odds Ratio 0.04 (CI 0.002-0.795, p = 0.034)]. TNF-alpha, IL-1, Il-6 and Il-8 measurements upon admission differed between patients who died and those who survived (p < 0.01 for all comparisons).

CONCLUSIONS

In a population of elderly patients recently infected with Covid-19, CD10 + B cell levels were inversely correlated with clinical severity. Cytokine values upon admission were highly predictive of fatal outcome during hospitalisation. These findings could explain differences in the clinical presentation and allow rapid identification of patients at risk for complications.

Flukicides. IV. Crystal and Molecular Structure of 3'-Chloro-4'(p-chlorophenoxy)-3,5-diiodo-salicylanilide (Rafoxanide)

Orthorhombic crystals of rafoxanide, C19H11Cl2I2NO3, belong to the space group Pca21 with a 23.234(2), b 8.980(2), c 9.582(2)Ǻ and Z 4. The structure was solved by the heavy-atom method from diffractometer data measured with Mo Kα radiation. Refinement with anisotropic temperature factors given to the non-hydrogen atoms converged at R 0.059 for the 2025 observed terms. The two aromatic rings of the salicylanilide moiety are almost coplanar with a dihedral angle of 11.2°, whereas they are approximately perpendicular to the plane of the phenoxy group. Weak inter-molecular hydrogen-bond-like interactions between the nitrogen and carbonyl oxygen, which involve a glide motif, link the molecules into ribbons extending along the c axis.