Upper airway epithelial tissue transcriptome analysis reveals immune signatures associated with COVID-19 severity in Ghanaians.

The immunological signatures driving the severity of coronavirus disease 19 (COVID-19) in Ghanaians remain poorly understood. We performed bulk transcriptome sequencing of nasopharyngeal samples from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected Ghanaians with mild and severe COVID-19, as well as healthy controls to characterize immune signatures at the primary SARS-CoV-2 infection site and identify drivers of disease severity. Generally, a heightened antiviral response was observed in SARS-CoV-2-infected Ghanaians compared with uninfected controls. COVID-19 severity was associated with immune suppression, overexpression of proinflammatory cytokines, including CRNN, IL1A, S100A7, and IL23A, and activation of pathways involved in keratinocyte proliferation. SAMD9L was among the differentially regulated interferon-stimulated genes in our mild and severe disease cohorts, suggesting that it may play a critical role in SARS-CoV-2 pathogenesis. By comparing our data with a publicly available dataset from a non-African (Indians) (GSE166530), an elevated expression of antiviral response-related genes was noted in COVID-19-infected Ghanaians. Overall, the study describes immune signatures driving COVID-19 severity in Ghanaians and identifies immune drivers that could serve as potential prognostic markers for future outbreaks or pandemics. It further provides important preliminary evidence suggesting differences in antiviral response at the upper respiratory interface in sub-Saharan Africans (Ghanaians) and non-Africans, which could be contributing to the differences in disease outcomes. Further studies using larger datasets from different populations will expand on these findings

Additional file 6 of Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa

Additional file 6. Coronavirus disease 2019’s fatality rate in the world and Africa. The data was retrieved from WHO COVID-19 dashboard ( https://covid19.who.int/ ). The COVID-19 vaccine was rolled out in December 2020 worldwide and in February/March 2021 in Africa

Additional file 4 of Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa

Additional file 4. Cytokine concentration levels in COVID-19 patients. Comparison of cytokine concentration levels between COVID-19 symptomatic, asymptomatic patients, pre-COVID-19 health participants, COVID-19 pandemic health individuals and COVID-19 non-survivors. The cytokine concentration levels were measured from plasma of COVID-19 symptomatic (n = 29) and asymptomatic (n = 29), individuals, pre-COVID-19 health participants (100), COVID-19 pandemic health individuals (33) and COVID-19 non-survivors (2). The median quantity of the cytokines is shown by a horizontal line across the scatter plot while the lower and upper dotted lines represent the 25th and 75th percentiles, respectively. Statistical significance between symptomatic and asymptomatic patients were determined by a Kruskal-Wallis test with Dunn’s post hoc. (*: p 0.05)

Additional file 3 of Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa

Additional file 3. Antibody profiles among SARS-CoV-2 infected patients. A: The kinetics of IgG in asymptomatic individuals (n = 3) in response to SARS-CoV-2. Data represents the quantity of the multiple time points of the cytokines, B: Differential expression levels of IgG against SARS-CoV-2 spike and nucleocapsid proteins in symptomatic in response to COVID-19. Data represents the median quantity with the 25th and 75th percentiles

Additional file 2 of Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa

Additional file 2. Change on cytokine concentration levels over time in COVID-19 positive individuals. The cytokine concentration levels analysed from plasma of COVID-19 asymptomatic (n = 3), monthly for four months. The quantity of the cytokines for each sampling month is shown by the line graph

Additional file 8 of Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa

Additional file 8: Table S1. The median cytokine levels of healthy individuals (n = 124). Table S2. Heathy control samples used in the study

Additional file 5 of Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa

Additional file 5. The half-life of cytokines in asymptomatic and symptomatic patients. The cytokine concentration levels were for cytokines with significant difference between symptomatic and asymptomatic cases (14 cytokines), pro-inflammatory, anti-inflammatory and chemokines. The median half-life of the cytokines is shown by a horizontal line across the dot plot while the lower and upper dotted lines represent the 25th and 75th percentiles, respectively. Statistical significance between symptomatic and asymptomatic patients were determined by Mann-Whitney test (*: p 0.05)

Additional file 7 of Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa

Additional file 7. The Pearson correlation coefficient (r) between concentration levels of cytokines with significant difference between symptomatic and asymptomatic cases (14 cytokines), and baseline viral loads (Ct value) of the patients at p value<0.05