Abstract: Although the COVID-19 pandemic has left no country untouched there has been limited research to understand clinical and immunological responses in African populations. Here we characterise patients hospitalised with suspected (PCR-negative/IgG-positive) or confirmed (PCR-positive) COVID-19, and healthy community controls (PCR-negative/IgG-negative). PCR-positive COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-negative/IgG-positive and PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants exhibited a nasal and systemic cytokine signature analogous to PCR-positive COVID-19 participants, predominated by chemokines and neutrophils and distinct from PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants had increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. PCR-negative/IgG-positive individuals with high COVID-19 clinical suspicion had inflammatory profiles analogous to PCR-confirmed disease and potentially represent a target population for COVID-19 treatment strategies.
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Morton, B., Barnes, K., Anscombe, C., Jere, K., Matambo, P., Mandolo, J., Kamng’ona, R., Brown, C., Nyirenda, J., Phiri, T., Banda, N., Van Der Veer, C., Mndolo, K., Mponda, K., Rylance, J., Phiri, C., Mallewa, J., Nyirenda, M., Katha, G., Kambiya, P., Jafali, J., Mwandumba, H., Gordon, S., Cornick, J., Jambo, K. & Blantyre COVID-19 Consortium 2021, 'Distinct clinical and immunological profiles of patients with evidence of SARS-CoV-2 infection in sub-Saharan Africa', Nature Communications, 12, article no: 3554. https://doi.org/10.1038/s41467-021-23267-w