key: cord-0941882-cuva74k5 authors: Sandag, T.; Lkhagvasuren, E.; Batmunkh, M.; Ravjir, O. title: Some Clinical and Immunological Features of Imported COVID-19 Cases in Mongolia date: 2021-03-24 journal: nan DOI: 10.1101/2021.03.17.21253849 sha: 4641570495117ea0cca636d5ec2111c1dc9bc3fc doc_id: 941882 cord_uid: cuva74k5 SARS-CoV-2 disturbs the normal immune responses causing an uncontrolled inflammatory response in patients with severe COVID-19. The pattern of the immune response to the SARS-CoV-2 in individuals may fluctuate. Some have a virus-dependent protective immune response resulting in asymptomatic or mild disease with elimination of the virus within 7-10 days after onset of infection. Others develop virus non-dependent uncontrolled hyper-inflammation in the later period, leading to severe disease with cytokine storm, acute respiratory distress syndrome, disseminated intravascular coagulation and multi-organ failure. Methods: The serum of 72 patients was investigated for titers of 15 cytokines and chemokines using Enzyme-linked immunosorbent assay (ELISA) kits in the serum of peripheral blood samples. The means of groups were compared using ANOVA followed by Tukey multiple post hoc comparisons if the ANOVA p-value was <0.05. Results: Patients with pulmonary infiltrates on CT demonstrated a lower percentage of eosinophils (1.38{+/-}1.46%) and elevated level of serum CRP (8.57{+/-}19.10 mg/dL) compared to patients without pulmonary infiltrates (2.52{+/-}1.47% and 1.96{+/-}3.02 mg/dL respectively; p<0.05). ROC analysis for patients aged [≥]35 years showed patients with mild disease (n=3) had a significantly higher titer of IL-1 and MCP-1 (AUC, 0.958 and 0.917 respectively, p<0.05) compared to patients with moderate disease (n=7). Patients. SARS-CoV-2 was detected in 58 (80.5%) patients repatriated from Russia, 11 from Afghanistan, 3 from Kazakhstan, and 2 and 1 from Sweden and the USA, respectively. A total of 20 patients (27.8%) were classified as asymptomatic and 52 patients (72.2%) as symptomatic. Over two-thirds of hospitalized patients were diagnosed with a mild clinical form of the COVID-19 (190/276, 68.8%), and the remaining patients had a moderate form of the disease (86/276, 31.2%). None of the patients had severe disease, and there were no virus-related fatalities. Pulmonary infiltrates by chest CT were found in 15 patients with moderate disease later during their hospitalization. The demographic and epidemiological characteristics of patients according to clinical severity are shown in Table 1 . The hematological and blood chemistry features of patients determined in the early period of observation are shown in Table 2 . (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Seven patients with moderate disease and four patients with mild disease were used in the analysis.AUC, Area under the Curve All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. However, only the eosinophil percentage was shown by itself as an accurate classifier for developing pulmonary infiltrates (Figure 2 ). The development of pulmonary infiltrates was not age-dependent. Table 4 . Table 4 . Serum cytokine and chemokines titers of COVID-19 patients measured within 24 hours of hospitalization stratified by disease severity (n=72). All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All values are mean ± standard deviation. -total of asymptomatic and symptomatic None of the cytokine and chemokines group mean titers shown were significantly different. Furthermore, when was performed ROC analysis for patients aged Our study of patients with mild to moderate COVID-19 found few significant changes in peripheral blood and sera. This is probably because the majority of our patients were young and without chronic comorbidities and there were no cases of severe illness. However, when analyzing patients In our opinion, the most practical finding of our study was the reduced eosinophil percentage at hospital admission found in patients who later developed pulmonary infiltrates. The association of reduced peripheral blood eosinophil percentage, especially early in the course of the infection, with the severity and manifestation of hyperinflammatory response in the lung All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted March 24, 2021. ; https://doi.org/10.1101/2021.03.17.21253849 doi: medRxiv preprint parenchyma has been reported in several studies (10, [14] [15] [16] [17] . We hope that our findings will help predict the severity of COVID-19 in medical and public health facilities. The authors suggested that relatively young age of patients and absence of cases with severe illness were restricted the chance to find enough significant differences in hematological and immunological features according to disease course of SARS-CoV-2 infected patients in this study. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. 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