Cell Population Data and Serum Polyclonal Immunoglobulin Free Light Chains in the Assessment of COVID-19 Severity

Viruses. 2021 Jul 15;13(7):1381. doi: 10.3390/v13071381.

Abstract

Distinguishing between severe and nonsevere COVID-19 to ensure adequate healthcare quality and efficiency is a challenge for the healthcare system. The aim of this study was to assess the usefulness of CBC parameters together with analysis of FLC serum concentration in risk stratification of COVID-19.

Materials and methods: CBC was analyzed in 735 COVID ICU, COVID non-ICU, and non-COVID ICU cases. FLC concentration was analyzed in 133 of them.

Results: COVID ICU had neutrophils and lymphocytes with the greatest size, granularity, and nucleic acid content. Significant differences in concentrations of κ and λ FLCs were shown between COVID ICU and COVID non-ICU. However, no difference was found in the κ/λ ratio between these groups, and the ratio stayed within the reference value, which indicates the presence of polyclonal FLCs. FLC κ measurement has significant power to distinguish between severe COVID-19 and nonsevere COVID-19 (AUC = 0.7669), with a sensitivity of 86.67% and specificity of 93.33%. The κ coefficients' odds ratio of 3.0401 was estimated.

Conclusion: It can be concluded that the results obtained from the measure of free light immunoglobulin concentration in serum are useful in distinguishing between severe and nonsevere COVID-19.

Keywords: COVID-19; FLC; antibody synthesis lymphocytes.

MeSH terms

  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / immunology
  • COVID-19 / blood
  • COVID-19 / diagnosis
  • COVID-19 / immunology*
  • COVID-19 Serological Testing
  • Female
  • Ferritins / immunology
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Immunoglobulin Light Chains / immunology
  • Intensive Care Units
  • Interleukin-6 / immunology
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2 / immunology*
  • Sensitivity and Specificity
  • Severity of Illness Index

Substances

  • Immunoglobulin Light Chains
  • Interleukin-6
  • C-Reactive Protein
  • Ferritins