Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China

Abstract

were collected and analyzed. The data of laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between severe and non-severe patients. ResultsOf the 452 patients with COVID-19 recruited, 286 were diagnosed as severe infection. The median age was 58 years and 235 were male. The most common symptoms were fever, shortness of breath, expectoration, fatigue, dry cough and myalgia. Severe cases tend to have lower lymphocytes counts, higher leukocytes counts and neutrophil-lymphocyte-ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most of severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines.The number of T cells significantly decreased, and more hampered in severe cases. Both helper T cells and suppressor T cells in patients withCOVID-19 were below normal levels, and lower level of helper T cells in severe group. The percentage of naïve helper T cells increased and memory helper T cells decreased in severe cases. Patients with COVID-19 also have lower level of regulatory T cells, and more obviously damaged in severe cases. Downloaded from https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciaa248/5803306 by guest on 30 March 2020 5 ConclusionsThe novel coronavirus might mainly act on lymphocytes, especially T lymphocytes.Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis and treatment of COVID-19.

The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China

“…In some critical ill patients, NK cells were extremely low, or even undetectable. In addit ion, memo ry helper T cells and regulatory T cells were obviously decreased in severe cases [13].…”

COVID-19 illness in native and immunosuppressed states: A clinical–therapeutic staging proposal

“…COVID-19 infection results in a decrease in helper, suppressor and regulatory T cell counts. 9 Studies have shown that inflammatory cytokines and biomarkers such as interleukin (IL)-2, IL-6, IL-7, granulocyte-colony stimulating factor, macrophage inflammatory protein 1-α, tumor necrosis factor-α, Creactive protein, ferritin, and D-dimer are significantly elevated in those patients with more severe disease. 10 Troponin and N-terminal pro B-type natriuretic peptide (NT-proBNP) can also be elevated.…”

Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients

“…CD4 + T cell, CD8 + T cell, NLR) tend to be an independent predictor for COVID-19 severity and treatment efficacy. 9,18 The severity of pathological injury during SARS or MERS correlates with the extensive infiltration of neutrophils in the lung and increased neutrophil numbers in the peripheral blood. 19 Thus, the magnitude of increase in neutrophil counts may suggest the intensity of inflammatory responses in COVID-19 patients.…”

“…IL-6) in COVID-19 patients. 5,[8][9][10] However, it has remained largely unclear in the kinetics of lymphocyte subsets and inflammatory cytokines change in the peripheral blood during COVID-19. In this study, we longitudinally characterized the changes of lymphocyte subsets and cytokines profiles in the peripheral blood of COVID-19 patients with distinct disease severities.…”