Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia
Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia
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DOI：
10.1093/infdis/jiaa150
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发表时间：
2020-06-01
影响因子：
6.4
通讯作者：
Zhang, Yongxi
中科院分区：
文献类型：
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作者：
Wang, Fan;Nie, Jiayan;Zhang, Yongxi
背景2019年12月，武汉报告了新型冠状病毒（SARS-CoV-2）肺炎（COVID-19），此后迅速蔓延至中国各地。目的探讨COVID-19患者外周血淋巴细胞亚群改变的特点及临床意义。采用流式细胞仪检测60例住院COVID-19患者治疗前后外周血淋巴细胞亚群水平，分析其与临床特征及治疗效果的关系。COVID-19患者的总淋巴细胞、CD 4（+）T细胞、CD 8（+）T细胞、B细胞和自然杀伤（NK）细胞减少，重症病例的水平低于轻度病例。这些亚群与COVID-19的炎症状态显著相关，尤其是CD 8（+）T细胞和CD 4（+）/CD 8（+）比值。治疗后，37例（67%）患者出现临床反应，CD 8（+）T细胞和B细胞增加。在无反应病例中，未检测到任何子集的显著变化。多因素分析显示，治疗后CD 8（+）T细胞和B细胞减少以及CD 4（+）/CD 8（+）比值升高是疗效差的独立预测因素。外周血淋巴细胞亚群改变与COVID-19的临床特征和治疗效果相关。CD 8（+）T细胞往往是COVID-19严重程度和治疗效果的独立预测因子。
Background. In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19.Methods. The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed.Results. Total lymphocytes, CD4(+) T cells, CD8(+) T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8(+) T cells and CD4(+)/CD8(+) ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8(+) T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8(+) T cells and B cells and increase in CD4(+)/CD8(+) ratio were indicated as independent predictors of poor efficacy.Conclusions. Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8(+) T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy.