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. 2020 Jun;127:104361.
doi: 10.1016/j.jcv.2020.104361. Epub 2020 Apr 12.

The Clinical Course and Its Correlated Immune Status in COVID-19 Pneumonia

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Free PMC article

The Clinical Course and Its Correlated Immune Status in COVID-19 Pneumonia

Ruyuan He et al. J Clin Virol. .
Free PMC article

Abstract

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 cell (CD16+ 56+), were significantly lower in severe group (P<0.001). The dynamic levels of T lymphocyte 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.

Keywords: COVID-19; SARS-CoV-2; immunity; lymphocyte subsets.

Figures

Fig. 1
Fig. 1
Dynamic changes of lymphocyte subsets count between non-severe and severe group. The count of CD3+ T cell (A), CD4+ T cell (B), CD8+ T cell (C), B cell (D) and NK cell (E) were illustrated in chronological order. The solid lines (black) show the lower normal limit of each parameter. The dotted line (red) show the cut-off value calculated by ROC analysis. The sensitivity and specificity of lymphocyte subsets count (F) and level of humoral immune function (G) for classification of COVID-19. Error bars, mean ± sem.
Fig. 2
Fig. 2
Dynamic changes of lymphocyte subsets count between improved and dead group. The severe patients were divided into improved and dead groups according to the outcomes as of February 13. The count of CD3+ T cell (A), CD4+ T cell (B), CD8+ T cell (C), B cell (D) and NK cell (E) were illustrated in chronological order. The solid lines (black) show the lower normal limit of each parameter. The dotted line (red) show the cut-off value calculated by ROC analysis. Scatter plot described the correlation between TNF with CD3+ T cell (F), CD4+ T cell (G) and CD8+ T cell (H), respectively.

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References

    1. Huang C, Wang Y, Li X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497–506.
    1. Wang D, Hu B, Hu C. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;(February)
    1. Yang X, Yu Y, Xu J. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;(February)
    1. Chen N, Zhou M, Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507–513.
    1. Yang Y, Lu Q, Liu M. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. medRxiv. 2020 2020.02.10.20021675.

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