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

Abstract

Background: The dynamic changes of lymphocyte subsets and cytokines profiles of patients with novel coronavirus disease (COVID-19) and their correlation with the disease severity remain unclear. Method: Peripheral blood samples were longitudinally collected from 40 confirmed COVID-19 patients and examined for lymphocyte subsets by flow cytometry and cytokine profiles by specific immunoassays. Findings: Of the 40 COVID-19 patients enrolled, 13 severe cases showed significant and sustained decreases in lymphocyte counts but increases in neutrophil counts than 27 mild cases. Further analysis demonstrated significant decreases in the counts of T cells, especially CD8 + T cells, as well as increases in IL-6, IL-10, IL-2 and IFN-γ levels in the peripheral blood in the severe cases compared to those in the mild cases. T cell counts and cytokine levels in severe COVID-19 patients who survived the disease gradually recovered at later time points to levels that were comparable to those of the mild cases. Moreover, the neutrophil-to-CD8+ T cell ratio (N8R) were identified as the most powerful prognostic factor affecting the prognosis for severe COVID-19. Conclusion: The degree of lymphopenia and a proinflammatory cytokine storm is higher in severe COVID-19 patients than in mild cases, and is associated with the disease severity. N8R may serve as a useful prognostic factor for early identification of severe COVID-19 cases.

Risk factors related to hepatic injury in patients with corona virus disease 2019

“…Thus, loss of lymphocyte cells during SARS-CoV-2 infection may result in aggravated inflammatory responses. The significant decreases in the counts of lymphocyte cells, especially CD8 + T cells, as well as increases in IL-6, IL-10, IL-2 and IFN-γ levels in the peripheral blood of patients with COVID-19 24 .…”

Correlation Analysis Between Disease Severity and Inflammation-related Parameters in Patients with COVID-19 Pneumonia

“…Clinically, many patients appeared short-term progressive aggravation, scholars speculated that "inflammatory storms" occurred, namely, overreaction of cytokine. In a preprint article in medrxiv, the lymphocyte subsets and cytokines of 123 patients (102 mild and 21 severe patients) were analyzed and the researchers found the numbers of CD4+ T cells and CD8+ T cells decreased, and the levels of IL-6 and IL-10 increased in severe cases [7] . In this study, a retrospective analysis was conducted about cytokines and other inflammatory indicators of 100 patients (including 66 severe or critical patients), and more indicators were expected to better identify critical patients and help clinical decision-making.…”

“…S's study [7] . In this study, there was no significant difference about Ig A, Ig G, IgM , C3 and C4 concentrations, suggesting humoral immunity did not appear to play a key role in disease progression.…”

Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression

“…30 studies were included in the qualitative synthesis and meta-analysis [ Figure 1]. [3,8,[17][18][19][20][21][22][23][24][25][26]9,[27][28][29][30][31][32][33][34][35][36][10][11][12][13][14][15][16] There were a total of 6452 patients from 30 studies.…”