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COVID-19 Patients With Detectable Plasma Cells Have Better Survival Rate, Study Reveals

A study has revealed that patients with severe COVID-19 who have detectable plasma cells in the peripheral blood have better survival despite adjusting for covariates correlated with disease severity.

COVID-19 Patients With Detectable Plasma Cells Have Better Survival Rate, Study Reveals
Photo: Plasma Cells | InStyleHealth

What Are Plasma Cells?

Plasma cells are a type of immune cells that make large amounts of specific antibodies. These plasma cells develop from B cells that have been activated. Plasma cells are white blood cells called plasmacyte.

The plasma cells are differentiated B-lymphocyte white blood cells that are capable of secreting immunoglobulin or antibody. These cells play a significant role in adaptive immune response – being the main cells that are responsible for humoral immunity.

Without the plasma cells, a person is said to have agammaglobulinemia and is highly susceptible or at high risk of recurring infection. The hematopoietic lineage, structure and function of plasma cells are evaluated, along with the clinical presentations arising from improper plasma cell growth and development.

These plasma cells develop from antigen-activated B lymphocytes in secondary lymphoid organs, like the spleen and lymph nodes, following antigenic stimulation. Blimp-1, IRF4, and XBP-1 transcription factors are known to be essential in the differentiation of mature B cells into plasma cells.

Experts have identified hospitalized adult patients with confirmed SARS-CoV-2 infection and stratified by presence of plasma cells and World Health Organization or WHO disease severity using the Johns Hopkins COVID-19 Precision Medicine Analytics Platform Registry. To identify plasma cells, a sensitive flow cytometric screening method for highly fluorescent lymphocytes was applied and confirmed microscopically.

Lastly, time to death and time to clinical improvement by the presence of plasma cells in patients with severe disease were assessed using the Cox regression models.

These plasma cells were identified in 371 of 2,301 hospitalized patients with COVID-19. Patients with plasma cells were more likely to have severe disease, but 86.6% developed plasma cells after the onset of severe disease.

Following the adjustment for age, gender, body mass index (BMI), race or ethnicity, and other covariates correlated with the disease severity, those patients with plasma cells were found to have a lower risk of mortality.

Moreover, no significant correlation was observed between the presence of plasma cells and time to clinical improvement.

Researchers said that, “further investigation is warranted to understand the role of plasma cells in the immune response to COVID-19.”

The cytokines in severe COVID-19 are connected to proliferation, differentiation, and survival of plasma cells. The cells are not routinely found in peripheral blood; however, these may produce virus-neutralizing antibodies later in the course of an infection according to experts.

Source: Am J Med 2021;134:1029-1033

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