Overall reduced lymphocyte especially T and B subsets closely related to the poor prognosis and the disease severity in severe patients with COVID-19 and diabetes mellitus

Abstract

Background A dysregulated host immune response is common in patients with COVID-19. Aim In this study, we aimed to define the characteristics of lymphocyte subsets and their relationship with disease progression in COVID-19 patients with or without diabetes mellitus (DM). Methods The baseline peripheral lymphocyte subsets were compared between 55 healthy controls and 95 patients with confirmed COVID-19, and between severe and non-severe COVID-19 patients with or without DM. Results The prevalence of DM in the COVID-19 group was 20%, and patients with severe COVID-19 had a higher prevalence of DM than those with non-severe disease (P = 0.006). Moreover, a significantly poor prognosis and a higher rate of severity were found in those with DM relative to those without DM (P = 0.001, 0.003). Generally, all lymphocytes and subsets of lymphocytes, especially B and T cells, were significant reduced in COVID-19 patients, particularly in those with DM. Patients with severe COVID-19 and DM had the lowest lymphocyte counts compared with those with severe COVID-19 without DM, and those with non-severe COVID-19 with or without DM. Partially decreased lymphocyte subsets, age and DM were closely related to disease progression and prognosis. Conclusions These findings provide a reference for clinicians that immunomodulatory treatment may improve disease progression and prognosis of COVID-19 patients, especially those with severe disease with DM. Trial registration Chinese Clinical Trial Register ChiCTR2000034563

Pathological effects of SARS-CoV-2 on hematological and immunological cells: Alterations in count, morphology, and function

“…A decrease in both CD4+ and CD8+ T cells is reported in COVID-19 patients with different disease severities, which is more significant in severe and critical patients [43] , [45] , [51] , [52] , [54] , [57] , [58] , [60] . Histological analysis of deceased COVID-19 patients showed that the CD4+ and CD8+ T cells decreased in the spleen and lymph nodes of these patients [68] .…”

“…Lymphopenia following SARS-CoV-2 infection has been reported in many studies [43] , [44] , [45] , [46] , [47] , [48] , [49] . About 85% of patients who need to be hospitalized have lymphopenia [45] , [50] with a decrease in both T and B lymphocytes [44] , [45] , [51] , [52] , [53] , [54] . However, a study noted that the lymphocyte count remained in the normal range in mild COVID-19 patients [55] .…”

“…The B cell count is not affected by SARS-CoV-2 infection [47] , [55] , [56] even in the severe phase [55] . A decrease in lymphocyte populations can be used as a predictive parameter for determining the severity of the disease and the risk of death in patients with SARS-CoV-2 infection [43] , [50] , [52] , [53] , [54] , [55] , [57] , [58] . However, a recent systematic review found that a low lymphocyte level was correlated with a poor prognosis in general but the association between lymphocyte subsets and the mortality rate of COVID-19 patients was not significant [59] .…”

COVID Induced Functional Exhaustion and Persistently Reduced Lymphocytes as Vital Contributing Factors for Post-COVID Rhino-orbital and Cerebral Mucormycosis in Patients with Diabetes: Report from the Indian Sub-continent

“…Observations indicate that immune system dysfunction or dysregulated host immune response is commonly noted in individuals affected with COVID-19. The authors concluded that the immune-modulatory treatment should be considered to reduce disease progression and prognosis of COVID-19 patients, especially in patients with systemic co-morbidities [ 8 ].…”

Impact of the serum and blood biomarkers on the severity and survival of the COVID-19 infected patients with dementia

“…Moreover, our clinical data have revealed that increased NEU, decreased LYM, MONO, EOS, MPV, PCT, BASO, and INR levels in the deceased dementia patients infected by COVID-19 compared to the survived ones (Figure 6). Indicated changes in the blood biomarkers are tightly associated with a higher risk of mortality and disease progression [31]. Also with aging, leukocytosis, lymphocytopenia, neutrophilia, anemia, and severe in ammatory state were observed that are overlap with the COVID-19 pathology which may severe symptoms in the elderly patients [17].…”