B cell analysis in SARS-CoV-2 versus malaria: Increased frequencies of plasmablasts and atypical memory B cells in COVID-19

B cells play a central role in antiviral and antiparasitic immunity, not only as producers of antibodies, but also as APCs and mediators of inflammation. In this study, we used 16-color flow cytometry analysis to investigate the frequency, differentiation, and activation status of peripheral B cells of patients with SARS-CoV-2 infection or acute Plasmodium falciparum malaria compared with the healthy individuals. As a main result, we observed an increase of the frequency of (CD27(-), CD21(-)) atypical memory B cells and (CD19(+), CD27(+), CD38(+)) plasmablasts in malaria and COVID-19 patients. Additionally, CD86, PD-1, CXCR3, and CD39 expression was up-regulated, whereas CD73 was down-regulated on plasmablasts of COVID-19 and malaria patients compared with the bulk B cell population. In particular, there was a more pronounced loss of CD73(+) B cells in malaria. The frequency of plasmablasts positively correlated with serum levels of CRP, IL-6, and LDH of COVID-19 patients. In the longitudinal course of COVID-19, a rapid normalization of the frequency of atypical memory B cells was observed. The role and function of plasmablasts and atypical memory B cells in COVID-19 and other acute infections remain to be further investigated. The role of B cells as either driver or passenger of hyperinflammation during COVID-19 needs to be clarified.

Automated summary

This study utilized 16-color flow cytometry analysis to investigate peripheral B cells in patients with SARS-CoV-2 infection or acute Plasmodium falciparum malaria. The results showed an increase in atypical memory B cells and plasmablasts in these patients, along with changes in specific protein expression on the plasmablasts. These changes were positively correlated with inflammatory markers in COVID-19 patients.