CELLULAR AND HUMORAL IMMUNITY IN PATIENTS WITH COVID-19 CORRELATED WITH SEVERITY OF CLINICAL PRESENTATION AND SARS COV-2 VACCINATION STATUS

Abstract

Introduction. The COVID-19 pandemic has changed life across the planet, claiming approximately 7 mi- llion lives and more than 776 million cases reported globally, leaving many people with lasting sequelae. Of particular importance is understanding the immune system's defense responses against SARS-CoV-2 infection, with an emphasis on T-lymphocyte cells that modulate both cellular and humoral part. Aims. To determine epidemiological and clinical featu- res, especially comorbidities in patients who have had severe and mild COVID-19, to determine differences in cellular and humoral immune response and to co- rrelate with vaccination status for SARS CoV-2. Methods. A 6-month-prospective cohort study was conducted at the University Clinic for Pulmonology and Allergology and the Institute of Immunobiology and Human Genetics at the Faculty of Medicine - Skopje. The study included 88 patients with pre-exis- ting COVID-19 divided into two groups: patients with mild clinical manifestations and patients with severe clinical manifestations requiring hospitalization. The parameters of patients' medical history, number and type of comorbidities, parameters of cellular and hu- moral immune response, data on vaccination against SARS-CoV-2 were analyzed. Conclusion. The severity of the clinical presentation correlated directly with the number of comorbidities, and inversely with the vaccination status. Comorbidi- ties were present in 87.7% of patients with a severe clinical course. No correlation was found with the smoking status. The study showed that 97.72% of all patients had positive neutralizing antibodies for SARS- CoV-2. Positive cellular immunity had 54.55% of pa- tients, significantly higher in the group with severe COVID-19 and vaccinated patients. There was a posi- tive correlation between cellular and humoral immu- nity, but in 2 cases (4.16%) where the humoral respon- se was absent, a positive cellular response was verified.