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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Cite as

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

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Last updated: 16 June 2022
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