Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China
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- 12 March 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 71 (15), 762-768
- https://doi.org/10.1093/cid/ciaa248
Abstract
Background In December 2019, coronavirus 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China. Methods Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from 10 January to 12 February 2020 were collected and analyzed. The data on laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between patients with severe and nonsevere infection. Results Of the 452 patients with COVID-19 recruited, 286 were diagnosed as having 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 lymphocyte counts, higher leukocyte counts and neutrophil-lymphocyte ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines. The number of T cells significantly decreased, and were more impaired in severe cases. Both helper T (Th) cells and suppressor T cells in patients with COVID-19 were below normal levels, with lower levels of Th cells in the severe group. The percentage of naive Th cells increased and memory Th cells decreased in severe cases. Patients with COVID-19 also have lower levels of regulatory T cells, which are more obviously decreased in severe cases. Conclusions The 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.Keywords
This publication has 19 references indexed in Scilit:
- MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profileCytokine, 2018
- Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathologySeminars in Immunopathology, 2017
- Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratioPLOS ONE, 2017
- Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severityScientific Reports, 2016
- Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients with Sepsis: A Prospective Observational StudyMediators of Inflammation, 2016
- Age-dependent dysregulation of innate immunityNature Reviews Immunology, 2013
- When aging reaches CD4+ T-cells: phenotypic and functional changesFrontiers in Immunology, 2013
- FOXP3+ regulatory T cells in the human immune systemNature Reviews Immunology, 2010
- Plasma inflammatory cytokines and chemokines in severe acute respiratory syndromeClinical and Experimental Immunology, 2004
- Regulatory T Cells: Key Controllers of Immunologic Self-ToleranceCell, 2000