The clinical course and its correlated immune status in COVID-19 pneumonia

Abstract

Phone No: +86 18071093208 Word count of abstract: 215 Word count of text: 2483 Highlights  The immune status is significantly different between severe and non-severe COVID-19  The decrease of T lymphocyte correlated with the course of patients with COVID-19  The level of T lymphocyte is an indicator for severity and prognosis of COVID-19Abstract: Objectives: To explore the clinical course and its dynamic features of immune status in COVID-19 patients and find predictors correlated with severity and prognosis of COVID-19. Methods: The electronic medical records of 204 patients with COVID-19 pneumonia confirmed by nucleic acid testing were retrospectively collected and analyzed. Results: All Patients were divided into severe (69) and non-severe group (135). Lymphocyte subsets count, including CD3+ T cell, CD4+ T cell, CD8+ T cell, B cell (CD19+) and NK J o u r n a l P r e -p r o o f cell (CD16+56+), were significantly lower in severe group (P＜0.001). The dynamic levels of T lymphocytes in severe group were significantly lower from disease onset, but in the improved subgroup the value of T lymphocyte began to increase after about 15-day treatment and finally returned to the normal level. The cut-off value of the counts of CD3+ (576), CD4+ (391) and CD8+ (214) T cell were calculated and indicated significantly high sensitivity and specificity for severity of COVID-19. Conclusion: Our results shown that the decrease of CD3+, CD4+ and CD8+ T lymphocyte correlated with the course of patients with COVID-19 pneumonia, especially in severe cases. The level of T lymphocyte could be used as an indicator for prediction of severity and prognosis of patients with COVID-19 pneumonia. The application of glucocorticoid should be cautious in severe cases. IgE, IU/mL <100 23.5 (17.3-80.8) 21.9 (17.3-84.3) 30.85 (17.3-68.9) 0.707J o u r n a l P r e -p r o o f

Robust T cell immunity in convalescent individuals with asymptomatic or mild COVID-19

“…Our preliminary analyses showed that the absolute numbers and relative frequencies of CD4 + and CD8 + T cells were unphysiologically low in patients with acute moderate or severe COVID-19 ( Figure 1A and Figure S2A, B). This finding has been reported previously (He et al, 2020a;Liu et al, 2020). We then used a 31-parameter flow cytometry panel to assess the phenotypic landscape of these immune perturbations in direct comparisons with healthy blood donors and individuals who had recovered from asymptomatic/mild COVID-19 acquired early during the pandemic (February to March 2020).…”

Lymphocyte Subset Counts in COVID‐19 Patients: A Meta‐Analysis

“…CD4+ and/or CD8+ T‐cell counts from COVID‐19 patients with different disease severity status were reported in all 20 publications, and 10 of them also included CD19+ B cell and CD16 + CD56+ NK cell counts. These 20 peer‐reviewed publications were selected for meta‐analysis in this brief report (6‐25).…”

Association of immunological features with COVID-19 severity: a systematic review and meta-analysis

“…CD4 + T cells could activate the CD8 + T cell response to acute respiratory virus infection [18]. SARS-CoV-2 and associated autoimmune antibodies may lead to growth inhibition and apoptosis of hematopoiesis [19], which may decrease the production and maturation of immune cells [4].…”

“…Regarding cytokines, the conclusions of different studies are also inconsistent. With the exception of one study on IL-6 [4] and another study on TNF-α, most of our included studies, found that of IL-6 and TNF-α levels were signi cantly higher in severe cases compared with mild cases [3,13,17,20]. Some of our included studies found no signi cant differences in the levels of IL-2, IL-4, IL-5, and IFN-γ, while an nearly equivalent number of studies of each indicator found that they were signi cantly higher in severe cases.…”

“…Qin et al showed that the increase in cytokines levels (tumor necrosis factor alpha (TNF-α), interleukin-5 (IL-5), IL-6 and IL-10) correlated with COVID-19 course, especially in severe cases [3]. However, other studies revealed no signi cant differences in CD4 + and CD8 + T cell [3] and some cytokines (IL-5, IL-6 and IL-10) [4] between severe cases and mild cases. Thus, we presented a meta-analysis of 15 studies in order to assess the association between immune cells (CD4 + T, CD8 + T, CD3 + T, Treg, B, and NK cells) and cytokines (TNF-α, interferon gamma (IFN-γ), IL-2, IL-4, IL-5, IL-6 and IL-10) and COVID-19 severity.…”