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09 28, 2020;10 (1): 15838.

Immune dysfunction following COVID-19, especially in severe patients.

Cong-Ying Song, Jia Xu, Jian-Qin He, Yuan-Qiang Lu
Author Information
  1. Cong-Ying Song: Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.
  2. Jia Xu: Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.
  3. Jian-Qin He: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.
  4. Yuan-Qiang Lu: Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China. luyuanqiang@zju.edu.cn.
PMID: 32985562 DOI: 10.1038/s41598-020-72718-9

Abstract

The coronavirus disease 2019 (COVID-19) has been spreading worldwide. Severe cases quickly progressed with unfavorable outcomes. We aim to investigate the clinical features of COVID-19 and identify the risk factors associated with its progression. Data of confirmed SARS-CoV-2-infected patients and healthy participants were collected. Thirty-seven healthy people and 79 confirmed patients, which include 48 severe patients and 31 mild patients, were recruited. COVID-19 patients presented with dysregulated immune response (decreased T, B, and NK cells and increased inflammatory cytokines). Also, they were found to have increased levels of white blood cell, neutrophil count, and D-dimer in severe cases. Moreover, lymphocyte, CD4 T cell, CD8 T cell, NK cell, and B cell counts were lower in the severe group. Multivariate logistic regression analysis showed that CD4 cell count, neutrophil-to-lymphocyte ratio (NLR) and D-dimer were risk factors for severe cases. Both CT score and clinical pulmonary infection score (CPIS) were associated with disease severity. The receiver operating characteristic (ROC) curve analysis has shown that all these parameters and scores had quite a high predictive value. Immune dysfunction plays critical roles in disease progression. Early and constant surveillance of complete blood cell count, T lymphocyte subsets, coagulation function, CT scan and CPIS was recommended for early screening of severe cases.

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MeSH Term

Adult
Aged
B-Lymphocytes
Betacoronavirus
CD4-Positive T-Lymphocytes
CD8-Positive T-Lymphocytes
COVID-19
Coronavirus Infections
Female
Humans
Immune System Phenomena
Killer Cells, Natural
Lymphocyte Count
Male
Middle Aged
Neutrophils
Pandemics
Pneumonia, Viral
Retrospective Studies
SARS-CoV-2
Severity of Illness Index
Treatment Outcome
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 69

Word Cloud

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