Immune profiles to distinguish hospitalized versus ambulatory COVID-19 cases in older patients

Jéromine Klingler, Gregory S. Lambert, Juan C. Bandres, Rozita Emami-Gorizi, Arthur Nádas, Kasopefoluwa Y. Oguntuyo, Fatima Amanat, Maria C. Bermúdez-González, Charles Gleason, Giulio Kleiner, Viviana Simon, Benhur Lee, Susan Zolla-Pazner, Chitra Upadhyay, Catarina E. Hioe

Research output: Contribution to journalArticlepeer-review


A fraction of patients with COVID-19 develops severe disease requiring hospitalization, while the majority, including high-risk individuals, experience mild symptoms. Severe disease has been associated with higher levels of antibodies and inflammatory cytokines but often among patients with diverse demographics and comorbidity status. This study evaluated hospitalized vs. ambulatory patients with COVID-19 with demographic risk factors for severe COVID-19: median age of 63, >80% male, and >85% black and/or Hispanic. Sera were collected four to 243 days after symptom onset and evaluated for binding and functional antibodies as well as 48 cytokines and chemokines. SARS-CoV-2-specific antibody levels and functions were similar in ambulatory and hospitalized patients. However, a strong correlation between anti-S2 antibody levels and the other antibody parameters, along with higher IL-27 levels, was observed in hospitalized but not ambulatory cases. These data indicate that antibodies against the relatively conserved S2 spike subunit and immunoregulatory cytokines such as IL-27 are potential immune determinants of COVID-19.

Original languageEnglish
Article number105608
Issue number12
StatePublished - 22 Dec 2022


  • Health sciences
  • Immune response
  • Immunology
  • Population


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