Jenniffer C. Sang

Conference 2024 Live Talk

Talk Title

Cytokine immune profiles among COVID 19 patients with different disease severities seeking treatment at Moi Teaching and Referral Hospital, Kenya

Authors and Affiliations

Jenniffer C. Sang 1, 2, Stanslaus K. Musyoki 3, Wilfred E. Injera 4, Geoffrey K. K. Maiyoh 5
1. Department of Medical Laboratory Sciences, School of Health Sciences, Kisii University, Kisii, Kenya.
2. Department of Laboratory Services, Moi Teaching and Referral Hospital, Eldoret, Kenya.
3. Department of Medical Laboratory Sciences, School of Health Sciences, South Eastern Kenya University.
4. Department of Medical Laboratory Sciences, School of Health Sciences, Alupe University, Busia, Kenya.
5. Department of Biochemistry and Clinical Chemistry, School of Medicine, Moi University, Eldoret, Kenya.

Abstract

Background

COVID 19 presents with a wide spectrum of severities including asymptomatic, mild, moderate and severe. Studies have shown that the evaluation of immunological profiles among SARS-CoV-2 positive patients have the potential to serve as an early indicator for the disease severity. There is need to determine cytokine profiles that are associated with/ potentially, predictive of these disease severities among COVID patients to aid in placing patients in care priority groups.

Methods

Archived patient plasma samples were retrieved from the AMPATH Bio-repository with approximately equal representation among males and females and disease severities. Socio-demographic data including disease severities was abstracted from patient health records files. Pro-inflammatory cytokines (IFλ, TNFα, IL2 and IL17) and anti-inflammatory cytokines (IL4, IL6 and IL10) levels were assayed using BD FACSCalibur flowcytometer according to the manufactures instructions. Data was analyzed for proportions of cytokines levels and compared across varied disease severities. Demographic data was expressed as means ± SD with P≤0.05 being considered significant.

Results

Males and females had mean ages of 49.6 ±22.7 and 48.4 ±23.7 respectively. Mean ages for disease severity categories were 33± 19, 45.2 ± 21.5, 56.8± 18.7 and 61.95± 22 for asymptomatic, moderate, severe and critical respectively. 25% had one or more underlying comorbidities. Among those with comorbidities, 6 %, 17.6 %, 34 % and 41 % were asymptomatic, moderate, severe and critical groups respectively. CVD (41%), pulmonary disease 31%, Hypertension (16%), diabetes 16% and malignancy (13%) were the most prevalent. Predominant symptoms among critical patients were dyspnea (63%) and myalgia (60%). Rhinorrhea (46.2%) and chest pain (45.7%) predominated among severe category. Diarrhea, joint pain and abdominal pain were only observed in severe and the critical groups.
IFN-γ, TNF‐α and IL17 showed good linearity with their levels rising steadily with increasing disease severity. For the anti-inflammatory cytokines, a marked rise was seen for IL-6 and IL-10 with increasing disease severity.

Conclusions

TNF-α, IL-17 and IL – 6 levels correlated with disease severities and may serve as prognosis predictor biomarkers. Advanced age and underlying comorbidities were also independently associated with disease severity.