Introduction.

SARS-CoV-2, is causal agent of COVID-19. This virus causes infections that range from asymptomatic to symptomatic infection, with variable grade of severity. Cytokine storm, characterized for uncontrolled releasing of inflammatory mediators, has effect in the immunopathology of COVID-19. The aim was to evaluate if viral titers and unbalance of early immune response determined the clinical presentation of SARS-CoV-2 infection.

Methods.

Real time PCR was used to identify the level of SARS-CoV-2 replication in nasopharyngeal swabs (NPS). Expression of pro- inflammatory mediators with antiviral (IFN-γ) and chemokine (RANTES) functions were evaluated. TGFβ-1 anti-inflammatory cytokine was also determined. In cells collected from NPS. It was studied SARS-CoV-2 asymptomatic and symptomatic individuals; with 10 days or less of onset symptoms or contact with source of infection. A control group negative to virus was used to compare the results.

Results.

Level of viral replication was similar in individuals independently of their symptoms. It was identified a high expression of IFN-γ in SARS-CoV-2 infected subjects, which was significantly increased in symptomatic patients in comparison to controls (p = 0,0393). TGF-β1 and RANTES expression were lower in SARS-CoV-2 positive cases. It was observed a positive and significant correlation between IFN-γ and TGF-β1 in asymptomatic cases (r = +0,61, p = 0,0014). As a conclusion, the findings suggest an unbalance between pro-and anti-inflammatory mediators determinates the clinical presentation of SARS-CoV-2 infection.

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