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Dynamic changes in lymphocyte subsets and parallel cytokine levels in patients with severe and critical COVID-19.
BMC Infect Dis. 2021 Jan 18; 21(1):79.BI

Abstract

BACKGROUND

The lack of knowledge regarding the pathogenesis and host immune response during SARS-CoV-2 infection has limited the development of effective treatments. Thus, we longitudinally investigated the dynamic changes in peripheral blood lymphocyte subsets and parallel changes in cytokine levels in COVID-19 patients with different disease severities to further address disease pathogenesis.

METHODS

A total of 67 patients (10 moderate, 38 severe and 19 critical cases) with COVID-19 admitted to a tertiary care hospital in Wuhan from February 8th to April 6th, 2020 were retrospectively studied. Dynamic data of lymphocyte subsets and inflammatory cytokines were collected.

RESULTS

On admission, compared with moderate cases, severe and critical cases showed significantly decreased levels of total lymphocytes, T lymphocytes, CD4+ T cells, CD8+ T cells, B cells and NK cells. IL-6 and IL-10 were significantly higher in the critical group. During the following hospitalization period, most of the lymphocyte subsets in the critical group began to recover to levels comparable to those in the severe group from the fourth week after illness onset, except for NK cells, which recovered after the sixth week. A sustained decrease in the lymphocyte subsets and an increase in IL-6 and IL-10 were observed in the nonsurvivors until death. There was a strong negative correlation between IL-6 and IL-10 and total lymphocytes, T lymphocytes, CD4+ T cells, CD8+ T cells and NK cells.

CONCLUSIONS

A sustained decrease in lymphocyte subsets, especially CD4+ T cells and NK cells, interacting with proinflammatory cytokine storms was associated with severe disease and poor prognosis in COVID-19.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China.Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China.Thoracic surgery department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Province Hubei, People's Republic of China.Thoracic surgery department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Province Hubei, People's Republic of China.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China. hui-yisums@163.com.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China. stevenkyk@hotmail.com.Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People's Republic of China. lyif@mail.sysu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33461503

Citation

Liu, Yangli, et al. "Dynamic Changes in Lymphocyte Subsets and Parallel Cytokine Levels in Patients With Severe and Critical COVID-19." BMC Infectious Diseases, vol. 21, no. 1, 2021, p. 79.
Liu Y, Tan W, Chen H, et al. Dynamic changes in lymphocyte subsets and parallel cytokine levels in patients with severe and critical COVID-19. BMC Infect Dis. 2021;21(1):79.
Liu, Y., Tan, W., Chen, H., Zhu, Y., Wan, L., Jiang, K., Guo, Y., Tang, K., Xie, C., Yi, H., Kuang, Y., & Luo, Y. (2021). Dynamic changes in lymphocyte subsets and parallel cytokine levels in patients with severe and critical COVID-19. BMC Infectious Diseases, 21(1), 79. https://doi.org/10.1186/s12879-021-05792-7
Liu Y, et al. Dynamic Changes in Lymphocyte Subsets and Parallel Cytokine Levels in Patients With Severe and Critical COVID-19. BMC Infect Dis. 2021 Jan 18;21(1):79. PubMed PMID: 33461503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dynamic changes in lymphocyte subsets and parallel cytokine levels in patients with severe and critical COVID-19. AU - Liu,Yangli, AU - Tan,Weiping, AU - Chen,Haihong, AU - Zhu,Ying, AU - Wan,Li, AU - Jiang,Ke, AU - Guo,Yubiao, AU - Tang,Kejing, AU - Xie,Canmao, AU - Yi,Hui, AU - Kuang,Yukun, AU - Luo,Yifeng, Y1 - 2021/01/18/ PY - 2020/06/02/received PY - 2021/01/12/accepted PY - 2021/1/19/entrez PY - 2021/1/20/pubmed PY - 2021/1/23/medline KW - COVID-19 KW - Cytokine storm KW - Dynamic changes KW - Lymphocyte subsets KW - SARS-CoV-2 SP - 79 EP - 79 JF - BMC infectious diseases JO - BMC Infect Dis VL - 21 IS - 1 N2 - BACKGROUND: The lack of knowledge regarding the pathogenesis and host immune response during SARS-CoV-2 infection has limited the development of effective treatments. Thus, we longitudinally investigated the dynamic changes in peripheral blood lymphocyte subsets and parallel changes in cytokine levels in COVID-19 patients with different disease severities to further address disease pathogenesis. METHODS: A total of 67 patients (10 moderate, 38 severe and 19 critical cases) with COVID-19 admitted to a tertiary care hospital in Wuhan from February 8th to April 6th, 2020 were retrospectively studied. Dynamic data of lymphocyte subsets and inflammatory cytokines were collected. RESULTS: On admission, compared with moderate cases, severe and critical cases showed significantly decreased levels of total lymphocytes, T lymphocytes, CD4+ T cells, CD8+ T cells, B cells and NK cells. IL-6 and IL-10 were significantly higher in the critical group. During the following hospitalization period, most of the lymphocyte subsets in the critical group began to recover to levels comparable to those in the severe group from the fourth week after illness onset, except for NK cells, which recovered after the sixth week. A sustained decrease in the lymphocyte subsets and an increase in IL-6 and IL-10 were observed in the nonsurvivors until death. There was a strong negative correlation between IL-6 and IL-10 and total lymphocytes, T lymphocytes, CD4+ T cells, CD8+ T cells and NK cells. CONCLUSIONS: A sustained decrease in lymphocyte subsets, especially CD4+ T cells and NK cells, interacting with proinflammatory cytokine storms was associated with severe disease and poor prognosis in COVID-19. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/33461503/Dynamic_changes_in_lymphocyte_subsets_and_parallel_cytokine_levels_in_patients_with_severe_and_critical_COVID_19_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05792-7 DB - PRIME DP - Unbound Medicine ER -