The predicting value of circular DNA particles of T- and B-cell receptors for the dismal acute period outcomes and the disease severity of COVID-19 infection

Abstract

The pandemic of the new coronavirus infection COVID-19, caused by the SARS-CoV-2 virus, continues to be a serious problem for the entire global community. Currently, most patients experience mild COVID-19, with only about 20% of those infected requiring hospitalization. The severe course of COVID-19 is most often associated with damage to the patient’s bronchopulmonary system by the virus and serious abnormalities, including damage to the air-hematological barrier, systemic inflammation, dysfunction of the immune system and the addition of secondary infections. Severe disease and poor outcome in hospitalized patients with COVID-19 may be associated with lymphopenia in combination with neutrophilia. Restoring the number of lymphocytes is important to improve the prognosis of the patient’s outcome. Patients with COVID-19 experience an immune imbalance where systemic inflammation and dysfunction of circulating T and B cells lead to more severe disease. TREC/KREC analysis can characterize the function of the central organs of the immune system and its relationship with clinical and laboratory data. Decreased TREC/KREC levels were observed in patients with unfavorable disease outcomes compared to patients with favorable disease outcomes. Additionally, a higher neutrophil to lymphocyte ratio was found. Levels of TREC and KREC in the blood negatively correlate with the neutrophil-lymphocyte ratio. Thus, the TREC/KREC assay is a potential prognostic marker for assessing the severity and outcome of COVID-19.