Immunological and inflammatory profiles in mild and severe cases of COVID-19

Nat Commun. 2020 Jul 8;11(1):3410. doi: 10.1038/s41467-020-17240-2.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus / immunology
  • Betacoronavirus / pathogenicity*
  • Biomarkers / metabolism
  • CD4-Positive T-Lymphocytes / immunology
  • CD4-Positive T-Lymphocytes / pathology
  • CD8-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / pathology
  • COVID-19
  • Chemotaxis, Leukocyte
  • China / epidemiology
  • Coronavirus Infections / blood
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / pathology*
  • Coronavirus Infections / virology
  • Cytokines / blood
  • Female
  • Humans
  • Inflammation
  • Killer Cells, Natural / immunology
  • Killer Cells, Natural / pathology
  • Leukocyte Count
  • Lung / immunology
  • Lung / virology
  • Lymphocyte Activation
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / pathology*
  • Pneumonia, Viral / virology
  • SARS-CoV-2

Substances

  • Biomarkers
  • Cytokines