Clinical significance of changes in peripheral blood T lymphocyte subsets in patients with coronavirus disease 2019

doi:10.3877/cma.j.issn.1674-0785.2020.10.002

Abstract

Abstract:

Objective

To investigate the clinical significance of changes of peripheral blood T lymphocyte subsets in patients with coronavirus disease 2019 (COVID-19).

Methods

The changes of lymphocyte subsets in peripheral blood of 507 patients with COVID-19 who were admitted to People's Hospital of Wuhan University on January 23, 2020 and March 10, 2020 were retrospectively analyzed. Among them, 249 cases had common-type COVID-19, 217 had severe-type, and 41 had critical-type.

Results

There were significant differences in the numbers of CD3⁺, CD4⁺, and CD8⁺ T cells in the peripheral blood among patients with common-type, severe-type, and critical-type COVID-19, and all showed a decreasing trend with the aggravation of disease degree. Compared with the common-type, the numbers of CD3⁺, CD4⁺, and CD8⁺ T cells in the severe- and critical-types were significantly decreased (P＜0.05), and the numbers of the above T lymphocyte subsets in the critical-type were significantly lower than those in the severe-type (P＜0.05). In addition, in 341 patients with COVID-19, the numbers of CD3⁺, CD4⁺, and CD8⁺ T lymphocytes in the death group was significantly lower than that in the cured group (P＜0.01).

Conclusion

Cellular immune function impairment is more significant in patients with severe and critical COVID-19, and the changes of T lymphocyte subsets in peripheral blood are significantly correlated with the classification and prognosis of COVID-19, which is helpful to evaluate the severity of the disease and predict the prognosis.

Key words: COVID-19, T lymphocyte subsets, Cell-mediated immunity

Jingjing Ma, Dandan Wu, Jixiang Zhang, Gangyan Zhu, Guozhong Chen, Yingjie Yang, Yuan Lei, Wenhao Su, Weiguo Dong. Clinical significance of changes in peripheral blood T lymphocyte subsets in patients with coronavirus disease 2019[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(10): 759-763.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2020.10.002

https://zhlcyszz.cma-cmc.com.cn/EN/Y2020/V14/I10/759

Figures/Tables 5

References 17

1	World Health Organization. WHO Director-General's remarks at the media briefing on COVID-19 on 11 March 2020 [EB/OL]. (2020-03-11) [2020-03-11]. URL
2	Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China [J]. Nature, 2020,579(7798): 265-269.
3	国家卫生健康委员会办公厅,国家中医药管理局办公室.新型冠状病毒肺炎诊疗方案(试行第七版)[EB/OL]. [2020-03-03]. URL
4	Arruga F, Gyau BB, Iannello A, et al. Immune Response Dysfunction in Chronic Lymphocytic Leukemia: Dissecting Molecular Mechanisms and Microenvironmental Conditions [J]. Int J Mol Sci, 2020,21(5): E1825.
5	国家卫生健康委员会办公厅,国家中医药管理局办公室.新型冠状病毒肺炎诊疗方案(试行第六版)[EB/OL]. [2020-2-18]. URL
6	Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China [J/OL]. N Engl J Med, 2020, 382(18): 1708-1720.
7	Xu Z, Shi L, Wang YJ, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome [J]. Lancet Respir Med, 2020, 8(4): 420-422.
8	宫恩聪, 高子芬, 郑杰, 等. 致死的严重急性呼吸综合征的病理变化及发病机制探讨 [J].中华传染病杂志, 2003, 21(6): 390-395.
9	Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [J]. Lancet, 2020, 395(10223): 497-506.
10	刘军, 谢正德, 徐保平, 等. 人冠状病毒在急性下呼吸道感染儿童中的临床特征 [J]. 中华实用儿科临床杂志, 2016, 31(4): 296-298.
11	Cannon JG, St Pierre BA. Gender differences in host defense mechanisms [J]. J Psychiatr Res, 1997, 31(1): 99-113.
12	Sombetzki M, Koslowski N, Rabes A, et al. Host defense versus immunosuppression: unisexual infection with male or female schistosoma mansoni differentially impacts the immune response against invading cercariae [J]. Front Immunol, 2018, 9: 861.
13	陈琼, 余维巍, 王丽静, 等. 老年人新型冠状病毒肺炎防治要点(试行) [J]. 中华老年医学杂志, 2020, 39(2): 113-118.
14	Moro-García MA, López-Iglesias F, Marcos-Fernández R, et al. More intensive CMV-infection in chronic heart failure patients contributes to higher T-lymphocyte differentiation degree [J]. Clin Immunol, 2018, 192: 20-29.
15	Dirksen C, Hansen BR, Kolte L, et al. T-lymphocyte subset dynamics in well-treated HIV-infected men during a bout of exhausting exercise [J]. Infect Dis (Lond), 2015, 47(12): 919-923.
16	尹炽标, 张复春, 唐小平, 等. 93例传染性非典型肺炎患者外周血T淋巴细胞亚群变化及临床意义 [J]. 中华结核和呼吸杂志, 2006, 26(6): 343-346.
17	Sato H, Adachi E, Lim LA, et al. CD4/CD8 ratio predicts the cellular immune response to acute hepatitis C in HIV-coinfected adults [J]. J Infect Chemother, 2019, 25(8): 646-648.

COVID-19疾病分型	列数	性别[例（%）]		年龄范围[例（%）]						年龄分布[岁，中位数（Q₁，Q₃）]
COVID-19疾病分型	列数	男	女	＜20岁	20~29岁	30~39岁	40~49岁	50~59岁	≥60岁	年龄分布[岁，中位数（Q₁，Q₃）]
普通型	249	97（39.0）	152（61.0）	1^a	18（7.2）	42（16.9）	48（19.3）	44（17.7）	96（38.5）	53（40.0，65.5）
重型	217	117（53.9）	100（46.1）	0^a	4^a	15（6.9）	28（12.9）	44（20.3）	126（58.1）	63（51.0，73.0）
危重型	41	29（70.7）	12（29.3）	0^a	0^a	2^a	2^a	5^a	32（78.0）	71（61.0，81.5）
统计值^b		χ²=8.116		χ²=17.377						Z=-5.787
P值^b		0.004		＜0.001						＜0.001
统计值^c		χ²=3.969		χ²=5.802						Z=-3.713
P值^c		0.046		0.016						＜0.001

COVID-19疾病分型	列数	性别[例（%）]		年龄范围[例（%）]						年龄分布[岁，中位数（Q₁，Q₃）]
COVID-19疾病分型	列数	男	女	＜20岁	20~29岁	30~39岁	40~49岁	50~59岁	≥60岁	年龄分布[岁，中位数（Q₁，Q₃）]
普通型	249	97（39.0）	152（61.0）	1^a	18（7.2）	42（16.9）	48（19.3）	44（17.7）	96（38.5）	53（40.0，65.5）
重型	217	117（53.9）	100（46.1）	0^a	4^a	15（6.9）	28（12.9）	44（20.3）	126（58.1）	63（51.0，73.0）
危重型	41	29（70.7）	12（29.3）	0^a	0^a	2^a	2^a	5^a	32（78.0）	71（61.0，81.5）
统计值^b		χ²=8.116		χ²=17.377						Z=-5.787
P值^b		0.004		＜0.001						＜0.001
统计值^c		χ²=3.969		χ²=5.802						Z=-3.713
P值^c		0.046		0.016						＜0.001

肺炎分型	例数	CD3⁺（723~2737个/μl）^a	CD4⁺（404~1612个/μl）^a	CD8⁺（220~1129个/μl）^a	CD4⁺/CD8⁺值（0.9~2）^a
普通型	249	930±383	572±269	327±147	2.0±1.3
重型	217	612±350^b	374±229^b	220±158^b	2.1±1.42
危重型	41	343±200^bc	214±124^bc	121±109^bc	2.7±2.3

肺炎分型	例数	CD3⁺（723~2737个/μl）^a	CD4⁺（404~1612个/μl）^a	CD8⁺（220~1129个/μl）^a	CD4⁺/CD8⁺值（0.9~2）^a
普通型	249	930±383	572±269	327±147	2.0±1.3
重型	217	612±350^b	374±229^b	220±158^b	2.1±1.42
危重型	41	343±200^bc	214±124^bc	121±109^bc	2.7±2.3

疾病预后	例数	CD3⁺（723~2737个/μl）^a	CD4⁺（404~1612个/μl）^a	CD8⁺（220~1129个/μl）^a	CD4⁺/CD8⁺值（0.9~2）^a
治愈	281	769±399	474±273	270±159	2.1±1.2
死亡	60	304±194^b	182±109^b	115±121^b	2.5±2.1

Please choose a citation manager

Content to export