Highlights
Higher mortality rate in COVID-19 patients with haematologic diseases.
Haematologic patients with COVID-19 have 50 % less chance of survival.
Probability of death was higher in patients older than 40 yrs of age with AML/MDS.
The dysregulation of both the innate and adaptive responses to SARS-CoV-2 have an impact on the course of COVID-19, and play a role in the clinical outcome of the disease. Here, we performed a comprehensive analysis of peripheral blood lymphocyte subpopulations in 82 patients with COVID-19, including 31 patients with a critical course of the disease. In COVID-19 patients who required hospitalization we analyzed T cell subsets, including Treg cells, as well as TCRα/β and γ/δ, NK cells, and B cells, during the first two weeks after admission to hospital due to the SARS-CoV-2 infection, with marked reductions in leukocytes subpopulations, especially in critically ill COVID-19 patients. We showed decreased levels of Th, Ts cells, Treg cells (both naïve and induced), TCRα/β and γ/δ cells, as well as CD16+CD56+NK cells in ICU compared to non-ICU COVID-19 patients. We observed impaired function of T and NK cells in critically ill COVID-19 patients with extremely low levels of secreted cytokines. We found that the IL-2/INFγ ratio was the strongest indicator of a critical course of COVID-19, and was associated with fatal outcomes. Our findings showed markedly impaired innate and adaptive responses in critically ill COVID-19 patients, and suggest that the immunosuppressive state in the case of a critical course of SARS-CoV-2 infection might reflect subsequent clinical deterioration and predict a fatal outcome.
patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented to the Gromkowski Regional Specialist Hospital in Wrocław (Poland) between March 6, 2020 and April 16, 2020 and had CXR performed on the day of admission. All cases of infection were confirmed with a RT-PCR test performed on the same day. The CXR results were analyzed by a radiologist and evaluated according to the chest radiograph scoring system proposed by Taylor et al. 5 Portable chest X-ray findings were categorized as: 1-normal; 2-patchy atelectasis and / or hyperinflation and / or bronchial wall thickening; 3-focal consolidation in a single lobe; 4-multifocal and bilateral consolidations; and 5-diffuse alveolar lesions. 5 The examination report, in addition to the CXR result, comprised the patient's medical history, symptoms and their duration, oxygen saturation, laboratory test results: complete blood count, capillary blood gas, and the levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), alanine aminotransferase, D-dimer, and ferritin. Disease severity was evaluated according to the World Health Organization definition (mild, moderate, or severe, including critical disease). 6 Neither ethics committee approval nor written patient consent were required, as it was a retrospective study based on medical records. Statistical analysis Nonparametric statistics was used to compare categorical variables between the study groups. To compare scores between 2 groups, we used the Mann-Whitney test, and to compare more than 2 groups, we used the Kruskal-Wallis test with the Games-Howell post hoc test. The correlation between scores and quantitative variables was assessed using the Spearman rank correlation
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