High SARS-CoV-2 Viral Load and Low <i>CCL5</i> Expression Levels in the Upper Respiratory Tract Are Associated With COVID-19 Severity
Felipe Pérez‐García, María Martin‐Vicente, Rosa Lía Rojas-García, Lucía Castilla-García, María José Muñoz‐Gómez, Irene Hervás Fernández, Victoria González Ventosa, Erick Joan Vidal-Alcántara, Juan Cuadros‐González, Jesús F. Bermejo-Martín, Salvador Resino, Isidoro Martínez
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.