Restoration of leukomonocyte counts is associated with viral clearance in COVID-19 hospitalized patients

Abstract

Background: Viral clearance is one important indicator for the recovery of SARS-CoV-2 infected patients. Suboptimal T and B cell responses can delay viral clearance in MERS and SARS patients. The role of leukomonocytes in viral clearance of COVID-19 patients is not yet well defined.Methods: From January 26 to February 28, 2020, an observational study was launched at Zhongnan Hospital of Wuhan University, Wuhan, China. We enrolled 25 laboratory-confirmed COVID-19 patients, whose throat-swab specimens were tested positive for SARS-CoV-2 infection by qRT-PCR. We comprehensively analyzed clinical records, counts of lymphocyte subsets including CD3+, CD4+, CD8+ T cells, B cells and NK cells in the patients who successfully cleared SARS-CoV-2, and compared to those that failed to, after a standardized treatment of 8-14 days. Findings: In 25 enrolled COVID-19 patients, lymphopeniawas a common feature. After the treatment, 14 patients were tested negative for SARS-CoV-2. The patients that cleared the infection had restored the numbers of CD3+, CD4+, CD8+ T cellsand B cells as compared to the still viral RNA positive patients, while the recovered patients had a higher count of leukomonocytes. Conclusions: By comparison of leukomonocytes counts in COVID-19 patients at different stages of the disease, we found that CD3+, CD4+, CD8+ T cells and B cells appear to play important roles in viral clearance. The restoration of leukomonocytes counts from peripheral blood can be used as prognosis for the recovery of an COVID-19 infection. We propose that restoration of leukomonocytes counts can be added to the COVID-19 diagnostic guidanceas a criterion for releasing and discharging patients.

Molecular mechanism of SARS-CoV-2 components caused ARDS in murine model

“…Thus, we propose that blocking JAK1 can inhibit the production of IL-6 in primary mouse macrophages, but not blocking JAK2, JAK1 may be necessary in IL-6 signaling transduction during the ALI. Impaired inflammatory responses in severe COVID-19 patients provide a distinct pattern of COVID-19 progression in host immune response to the SARS-Cov-2 infection, with pneumonia, lymphopenia, exhausted lymphocytes, high neutrophil to lymphocyte ratio, high production of IgG and a cytokine storm all being observed in severe cases of COVID-19 12,[31][32][33][34] . Both the innate and adaptive immune responses to control the virus infection are necessary, but whether protective or pathogenic host response remains to be determined.…”

Rethinking the role of hydroxychloroquine in the treatment of COVID‐19

“…It is important to note that as observed with SARS, patients with COVID‐19 can exhibit leuko‐ and lymphopenia, that NK and CD8 T‐cells exhibit markers (NKG2A, PD‐1) and diminished function consistent with exhaustion 48‐50 . Further, the extent of functional exhaustion and reduced diversity may correlate with the risk of severe disease, while restoration of monocytes and lymphocytes is linked with improved viral clearance and recovery 51‐53 . Key points to consider are summarized in Figure 2 and Table 2 and discussed in further detail below.…”

Comparativein vitrotranscriptomic analyses of COVID-19 candidate therapy hydroxychloroquine suggest limited immunomodulatory evidence of SARS-CoV-2 host response genes

“…We analyzed RNA-seq data of PBMC samples from three male individuals infected with SARS-CoV-2 and three control individuals without SARS-CoV-2 infection obtained from China (Supplemental Table 1) [20]. We first sought to confirm the observed immunological changes observed during COVID-19 disease in peripheral blood by others [15,[21][22][23][24]. We utilized the bulk transcriptome PBMC data and estimated the abundances of 22 immune cell types using the CIBERSORT analytical deconvolution tool [25].…”