Dynamic changes in peripheral blood lymphocyte subsets in adult patients with COVID-19
Dynamic changes in peripheral blood lymphocyte subsets in adult patients with COVID-19
复制标题
DOI：
10.1016/j.ijid.2020.07.003
复制
发表时间：
2020-09-01
影响因子：
8.4
通讯作者：
Xu, Yu
中科院分区：
文献类型：
--
作者：
Deng, Zhifeng;Zhang, Minli;Xu, Yu
导语：冠状病毒病2019年(新冠肺炎)，由感染严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起，现已广泛传播。本研究旨在探讨成人COVID-19患者外周血淋巴细胞亚群的动态变化。对435例确诊为SARS-CoV-2病毒感染的新冠肺炎住院患者的人口学特征、临床表现、合并症、实验室检查和放射学检查等资料进行回顾性分析。结果：各种淋巴细胞亚群(CD3+、CD4+、CD8+、CD19+、CD16/56+)在发病后1周低于正常范围，第2周降至最低点。第3周逐渐升高，第5周恢复正常，但仍低于健康对照组。结论：重症新冠肺炎患者外周血中CD_3~+、CD_4~+、CD_8~+细胞亚群水平与病情进展、病情严重程度及预后有关。动态监测人体免疫功能是评估新冠肺炎患者病情严重程度和预后的指标之一，有助于制定适当的治疗策略。(C)2020年提交人(S)。爱思唯尔有限公司代表国际传染病学会出版。
Introduction: Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread widely. The aim of this study was to investigate the dynamic changes in peripheral blood lymphocyte subsets in adult patients with COVID-19.Methods: The electronic medical records were reviewed. Data including demographic characteristics, clinical manifestations, comorbidities, laboratory data, and radiological examinations of 435 hospitalized COVID-19 patients with a confirmed SARS-CoV-2 viral infection were extracted and analyzed retrospectively. Lymphocyte subset counts at each week after the onset of the illness were compared with those of the other weeks of illness and with those of control individuals.Results: The various lymphocyte subsets (CD3+, CD4+, CD8+, CD19+, and CD16/56+) were below the normal ranges at 1 week after the onset of illness, reaching a nadir during the second week. They increased gradually during the third week and returned to normal levels in the fifth week, but were still lower than those of the healthy controls. The CD3+, CD4+, and CD8+ counts were significantly lower in patients with severe disease compared to those with non-severe disease, and in patients who died compared to those who recovered.Discussion: This research indicates that the levels of peripheral blood lymphocyte subsets (CD3+, CD4+, and CD8+) are associated with disease progression and severity, and with the prognosis in patients with COVID-19. Dynamic monitoring of human immune function is one of the indicators for evaluating the severity of disease and the prognosis of COVID-19 patients, and is useful for formulating appropriate treatment strategies. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.