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Reduced IFN-γ levels along with changes in hematologic and immunologic parameters are key to COVID-19 severity in
Mohammed Moinul Islam1, Shafiqul Islam2, Ridwan Ahmed1
1Department of Biochemistry & Molecular Biology, University of Chittagong, Chattogram, Bangladesh; EuGEF Research Foundation, Chattogram, Bangladesh.
Insights
Severe COVID-19 cases show immune dysregulation, with higher interleukin-6 and lower interferon-gamma. Key hematologic markers like neutrophils and platelets are altered, indicating a hyperinflammatory state in critical illness.
Area of Science:
- Immunology
- Hematology
- Infectious Diseases
Background:
- COVID-19 severity is linked to immune response dysregulation.
- Hematologic and immunologic parameters are altered in severe cases.
- Racial disparities may influence COVID-19 outcomes.
Purpose of the Study:
- Investigate biological, hematologic, and cytokine profiles in COVID-19 patients.
- Compare these parameters across mild, moderate, and severe disease groups.
- Identify biomarkers associated with severe COVID-19.
Main Methods:
- Analysis of cytokine profiles (IL-4, IL-6, IFN-γ).
- Measurement of hematologic parameters (WBC, neutrophils, lymphocytes, eosinophils, platelets).
- Assessment of inflammatory markers (ESR, ferritin, CRP, D-dimer).
Main Results:
- Severe COVID-19 patients had increased IL-4, IL-6, ESR, neutrophils, ferritin, CRP, and D-dimer.
- Severe cases showed reduced IFN-γ, WBC, lymphocytes, eosinophils, and platelets.
- Elevated ratios (IL-6/lymphocyte, NLR, PLR, LMR, ferritin/ESR) were observed in severe disease.
Conclusions:
- Increased IL-4, IL-6, CRP, and D-dimer suggest a hyperinflammatory state in severe COVID-19.
- Immune dysregulation, including reduced IFN-γ, contributes to disease severity.
- Hematologic ratios serve as potential indicators for COVID-19 severity.
Abstract:
The manifestation of coronavirus disease 2019 (COVID-19) severity and mortality has been associated with dysregulation of the immune response, often influenced by racial disparities and conferred by changes in hematologic and immunologic parameters. These biological and hematologic parameters as well as cytokine profiles were investigated in a cohort of 61 COVID-19-positive patients (categorized into mild, moderate, and severe groups) from Bangladesh using standard analytical methods. The data reported that the interleukin (IL)-4 and IL-6 levels were significantly increased, whereas the levels of interferon (IFN)-γ were significantly reduced in patients with severe COVID-19 (p < 0.05) compared with those in patients with mild and/or moderate COVID-19. The extent of erythrocyte sedimentation rate (ESR); neutrophil count; and levels of ferritin, C-reactive protein (CRP), and D-dimer (p < 0.05) were found to be significantly increased, whereas the white blood cell (WBC), lymphocyte, eosinophil, and platelet counts (p < 0.05) were observed to be significantly reduced in patients with severe COVID-19 compared with those in the patients in other 2 groups. Our study exhibited a significantly higher IL-6-to-lymphocyte ratio in patients with severe COVID-19 than in those with mild and moderate COVID-19. The calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and ferritin-to-ESR ratio were significantly increased in patients with severe COVID-19. The increase in the IL-4 and IL-6 levels along with CRP and D-dimer levels may envisage a hyperinflammatory environment and immune dysregulation, which contribute to prolonged viral persistence, leading to severe disease. However, the reduced level of IFN-γ can be attributed to a less fatality toll in Bangladesh compared with that in the rest of the world.
