Depletion of circulating IgM memory B cells predicts unfavourable outcome in COVID-19

Sci Rep. 2020 Nov 30;10(1):20836. doi: 10.1038/s41598-020-77945-8.

Abstract

Impaired immune responses have been hypothesised to be a possible trigger of unfavourable outcomes in coronavirus disease 2019 (COVID-19). We aimed to characterise IgM memory B cells in patients with COVID-19 admitted to an internal medicine ward in Northern Italy. Overall, 66 COVID-19 patients (mean age 74 ± 16.6 years; 29 females) were enrolled. Three patients (4.5%; 1 female) had been splenectomised and were excluded from further analyses. Fifty-five patients (87.3%) had IgM memory B cell depletion, and 18 (28.6%) died during hospitalisation (cumulative incidence rate 9.26/100 person-week; 5.8-14.7 95% CI). All patients who died had IgM memory B cell depletion. A superimposed infection was found in 6 patients (9.5%), all of them having IgM memory B cell depletion (cumulative incidence rate 3.08/100 person-week; 1.3-6.8 95% CI). At bivariable analyses, older age, sex, number of comorbidities, and peripheral blood lymphocyte count < 1500/µl were not correlated with IgM memory B cell depletion. A discrete-to-marked reduction of the B-cell compartment was also noticed in autoptic spleen specimens of two COVID-19 patients. We conclude that IgM memory B cells are commonly depleted in COVID-19 patients and this correlates with increased mortality and superimposed infections.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • B-Lymphocyte Subsets / cytology
  • B-Lymphocyte Subsets / immunology
  • B-Lymphocytes / cytology*
  • B-Lymphocytes / immunology
  • COVID-19 / mortality*
  • COVID-19 / pathology
  • Female
  • Hospital Mortality*
  • Humans
  • Immunoglobulin M / blood
  • Immunologic Memory / immunology*
  • Longitudinal Studies
  • Lymphocyte Count
  • Lymphocyte Depletion*
  • Male
  • Middle Aged
  • Prospective Studies
  • SARS-CoV-2 / immunology
  • Spleen / cytology
  • Spleen / immunology

Substances

  • Immunoglobulin M