High SARS-CoV-2 Viral Load and Low CCL5 Expression Levels in the Upper Respiratory Tract Are Associated With COVID-19 Severity

• Published in: The Journal of infectious diseases Vol. 225; no. 6; pp. 977 - 982
• Main Authors: Pérez-García, Felipe, Martin-Vicente, María, Rojas-García, Rosa Lía, Castilla-García, Lucía, Muñoz-Gomez, María José, Hervás Fernández, Irene, González Ventosa, Victoria, Vidal-Alcántara, Erick Joan, Cuadros-González, Juan, Bermejo-Martin, Jesús F, Resino, Salvador, Martínez, Isidoro
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 15-03-2022
• Subjects: Body fluids; Chemokine CCL5 - genetics; Chemokine CCL5 - metabolism; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - mortality; Humans; Immune clearance; Immune response; Immune system; Intensive Care Units; Major and Brief Reports; Mucosal immunity; Nasopharynx; Nasopharynx - virology; Nose; Pathophysiology; Replication; Respiratory tract; RNA, Viral - genetics; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Viral Load; COVID-19; SARS-CoV-2; viral load; death; innate immunity; CCL5; ICU; nasopharynx; gene expression
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiab604

Abstract
Mucosal immune response in the upper respiratory tract is crucial for initial control of viral replication, clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and progression of coronavirus disease 2019 (COVID-19). We analyzed SARS-CoV-2 RNA load and expression of selected immune genes in the upper respiratory tract (nasopharynx) of 255 SARS-CoV-2–infected patients and evaluated their association with severe COVID-19. SARS-CoV-2 replication in nasopharyngeal mucosa induces expression of several innate immune genes. High SARS-CoV-2 viral load and low CCL5 expression levels were associated with intensive care unit admission or death, although CCL5 was the best predictor of COVID-19 severity.
Graphical Abstract
Graphical Abstract