Immunological and inflammatory profiles in mild and severe cases of COVID-19
Immunological and inflammatory profiles in mild and severe cases of COVID-19
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COVID-19 轻度和重度病例的免疫学和炎症特征
DOI：
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发表时间：
2020
影响因子：
16.6
通讯作者：
Jiyuan Zhang
中科院分区：
文献类型：
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作者：
Jin;Chao Zhang;Xing Fan;F. Meng;Zhe Xu;P. Xia;Wen;Tao Yang;Xiao;Si;R. Xu;T. Jiang;Wen;Da;Peng Zhao;M. Shi;C. Agrati;G. Ippolito;M. Maeurer;Alimuddin Zumla;Fu;Jiyuan Zhang
COVID-19与5.1%的死亡率相关。尽管COVID-19患者的病毒学、流行病学、临床和管理结果特征已被迅速定义，但炎症和免疫特征仍需要定义，因为它们影响COVID-19的发病机制和临床表达。在这里，我们发现淋巴细胞减少症，选择性损失的CD 4 + T细胞，CD 8 + T细胞和NK细胞，过度的T细胞活化和高表达的T细胞抑制分子在严重的情况下比那些与轻度疾病更突出。严重疾病患者的CD 8 + T细胞表达高水平的细胞毒性分子。对一例死亡病例肺组织的组织化学研究显示，SARS-CoV-2 RNA的亚解剖分布以及T细胞和巨噬细胞的大量浸润。因此，CD 8 + T细胞的异常激活和失调发生在患有严重COVID-19疾病的患者中，这种效应可能是SARS-CoV-2感染的发病机制，并表明基于免疫的治疗干预靶点构成了一种有希望的治疗方法严重的COVID-19患者。对COVID-19患者的免疫表型分析正在进行中，但仍有许多有待了解。在本文中，作者分析了41例住院的COVID-19患者，结果显示，与轻度病例相比，重度病例的各种免疫细胞亚群中淋巴细胞减少程度以及细胞毒性和T细胞抑制标志物表达程度更高。
COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients. Immunophenotyping of patients with COVID-19 is ongoing, but much remains to be learned. Here the authors analyze 41 hospitalized patients with COVID-19 and show a higher degree of lymphopenia in various immune cell subsets as well as cytotoxicity and T cell inhibitory marker expression in severe cases compared with mild.