Lymphopenia in Covid-19: A single center retrospective study of 589 cases

Ghizlane, El Aidouni; Merbouh, Manal; Abderrahim, El Kaouini; Abdelilah, Elrhalete; Maarad, Mohammed; Alkouh, Rajae; Amine, Bouazzaoui Mohammed; Bkiyar, Houssam; Abda, Naïma; Housni, Brahim

doi:10.1016/j.amsu.2021.102816

Cited by 40 publications

(43 citation statements)

References 30 publications

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“…We found no significant alteration in the absolute number of NK cells or B cells ( Figure 2D ). Together, these data are reflective of the alterations in the levels of various immune cell types during COVID-19, in line with observations made by others ( 28 , 51 – 54 ).…”

Section: Resultssupporting

confidence: 91%

T cell perturbations persist for at least 6 months following hospitalization for COVID-19

et al. 2022

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COVID-19 is being extensively studied, and much remains unknown regarding the long-term consequences of the disease on immune cells. The different arms of the immune system are interlinked, with humoral responses and the production of high-affinity antibodies being largely dependent on T cell immunity. Here, we longitudinally explored the effect COVID-19 has on T cell populations and the virus-specific T cells, as well as neutralizing antibody responses, for 6-7 months following hospitalization. The CD8+ TEMRA and exhausted CD57+ CD8+ T cells were markedly affected with elevated levels that lasted long into convalescence. Further, markers associated with T cell activation were upregulated at inclusion, and in the case of CD69+ CD4+ T cells this lasted all through the study duration. The levels of T cells expressing negative immune checkpoint molecules were increased in COVID-19 patients and sustained for a prolonged duration following recovery. Within 2-3 weeks after symptom onset, all COVID-19 patients developed anti-nucleocapsid IgG and spike-neutralizing IgG as well as SARS-CoV-2-specific T cell responses. In addition, we found alterations in follicular T helper (TFH) cell populations, such as enhanced TFH-TH2 following recovery from COVID-19. Our study revealed significant and long-term alterations in T cell populations and key events associated with COVID-19 pathogenesis.

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Section: Resultssupporting

confidence: 91%

T cell perturbations persist for at least 6 months following hospitalization for COVID-19

et al. 2022

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“…We found no significant alteration in the absolute number of NK cells or B cells ( Figure 2B ). Together, these data are reflective of the alterations in the levels of various immune cell types during COVID-19, in line with observations made by others [25, 47–50].…”

Section: Resultssupporting

confidence: 91%

Long-term T cell perturbations and waning antibody levels in individuals needing hospitalization for COVID-19

Govender

Hopkins

Göransson

et al. 2022

Preprint

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COVID-19 is being extensively studied, and much remains unknown regarding the long-term consequences of the disease on immune cells. The different arms of the immune system are interlinked, with humoral responses and the production of high-affinity antibodies being largely dependent on T cell immunity. Here, we longitudinally explored the effect COVID-19 has on T cell populations and the virus-specific T cells, as well as neutralizing antibody responses, for 6-7 months following hospitalization. The CD8+ TEMRA and exhausted CD57+CD8+ T cells were markedly affected with elevated levels that lasted long into convalescence. Further, markers associated with T-cell activation were upregulated at the inclusion, and in the case of CD69+CD4+ T cells this lasted all through the study duration. The levels of T cells expressing negative immune checkpoint molecules were increased in COVID-19 patients and sustained for a prolonged duration following recovery. Within 2-3 weeks after symptom onset, all COVID-19 patients developed anti-nucleocapsid IgG and spike-neutralizing IgG as well as SARS-CoV-2-specific T cell responses. In addition, we found alterations in follicular T helper (TFH) cell populations, such as enhanced TFH-TH2 following recovery from COVID-19. Our study revealed significant and long-term alterations in T cell populations and key events associated with COVID-19 pathogenesis.

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“…Over-activation of neutrophils and their infiltration into the lung can be detrimental for COVID-19 patients and further result in lung injury and ARDS (Yang et al 2021 ; Hazeldine and Lord 2021 ). In addition, a low lymphocyte count (lymphopenia) has been associated with COVID-19 symptoms (Kong et al 2020 ; Ghizlane et al 2021 ). The improvement of NLR in patients that were treated with BAs suggests the immunomodulatory effect of these compounds.…”

Section: Discussionmentioning

confidence: 99%

Inflawell® improves neutrophil-to-lymphocyte ratio and shortens hospitalization in patients with moderate COVID-19, in a randomized double-blind placebo-controlled clinical trial

Tond

Balenci²,

Khajavirad

et al. 2022

Inflammopharmacol

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Aims COVID-19 is a significant global threat to public health. Despite the availability of vaccines and anti-viral drugs, there is an urgent need for alternative treatments to help prevent and/or manage COVID-19 symptoms and the underlying dysregulated immune response. We hypothesized that administration of Inflawell ® syrup, a Boswellia extract formulation enriched for boswellic acids (BAs), can reduce the excessive or persistent inflammation and thereby prevent disease progression. BAs are medicinally activated triterpenoids found in the resins of Boswellia spp ., and possess an immense therapeutic potential due to their anti-inflammatory and immunoregulatory activities. We investigated the effect of Inflawell ® syrup, on moderate COVID-19 patients along with the current standard of care treatment. Methods A randomized placebo-controlled double-blind clinical trial was conducted, following definitive confirmation of COVID-19. Forty-seven hospitalized patients with moderate COVID-19 were enrolled and received either the Inflawell ® syrup or placebo. Clinical symptoms and markers of inflammation were evaluated at baseline and completion of the trial. Results Our clinical trial revealed an increase in the percentage of oxygen saturation level in patients that received the BAs compared to placebo ( P < 0.0001). In addition, the average duration of hospitalization was significantly shorter in the BAs group compared with the placebo group ( P < 0.04). Concomitantly, some improvement in the clinical symptoms including cough, dyspnea, myalgia, headache, and olfactory and gustatory dysfunction were detected in the BAs group. Hematologic findings showed a significant decrease in the percentage of neutrophils ( P < 0.006) and neutrophil-to-lymphocyte ratio (NLR) levels ( P < 0.003), associated with a significant increase in the percentage of lymphocytes in the BAs group compared with the placebo ( P < 0.002). Additionally, a significant decrease in CRP, LDH, IL − 6 and TNF − α levels was detected in the BAs group. Following the intervention, fewer patients in the BAs group were PCR-positive for COVID-19 compared to placebo, though not statistically significant. Conclusion Overall, the treatment with Inflawell ® resulted in shorter hospital stay, alleviation of COVID-19 clinical symptoms and decline in the level of pro-inflammatory cytokines. Trial registration The trial has been registered in https://www.irct.ir with unique identifier: IRCT20170315033086N10 ( https://en.irct.ir/trial/51631 ). IRCT is a primary registry in the WHO registry network ( https://www...

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Lymphopenia in Covid-19: A single center retrospective study of 589 cases

Cited by 40 publications

References 30 publications

T cell perturbations persist for at least 6 months following hospitalization for COVID-19

T cell perturbations persist for at least 6 months following hospitalization for COVID-19

Long-term T cell perturbations and waning antibody levels in individuals needing hospitalization for COVID-19

Inflawell® improves neutrophil-to-lymphocyte ratio and shortens hospitalization in patients with moderate COVID-19, in a randomized double-blind placebo-controlled clinical trial

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