JCI Insight. The laboratory tests and host immunity of COVID-19 patients with different severity of illness

[tetano]

JCI Insight. 2020 Apr 23. pii: 137799. doi: 10.1172/jci.insight.137799. [Epub ahead of print]
The laboratory tests and host immunity of COVID-19 patients with different severity of illness.


Wang F¹, Hou H¹, Luo Y¹, Tang G¹, Wu S¹, Huang M¹, Liu W¹, Zhu Y¹, Lin Q¹, Mao L¹, Fang M², Zhang H³, Sun Z¹.

Author information




Abstract

BACKGROUND:

The Coronavirus Disease-2019 (COVID-19), infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a severe outbreak in China. The host immunity of COVID-19 patients is unknown.
METHODS:

The routine laboratory tests and host immunity in COVID-19 patients with different severity of illness were compared after patient admission.
RESULTS:

A total of 65 SARS-CoV-2-positive patients were classified as mild (n=30), severe (n=20), and extremely severe (n=15) illness. Many routine laboratory tests such as ferritin, lactate dehydrogenase and D-dimer were increased in severe and extremely severe patients. The absolute numbers of CD4+ T cells, CD8+ T cells and B cells were all gradually decreased with increased severity of illness. The activation markers such as HLA-DR and CD45RO expressed on CD4+ and CD8+ T cells were increased in severe and extremely severe patients compared with mild patients. The co-stimulatory molecule CD28 had opposite results. The percentage of natural regulatory T cells was decreased in extremely severe patients. The percentage of IFN-γ producing CD8+ T cells was increased in both severe and extremely severe patients compared with mild patients. The percentage of IFN-γ producing CD4+ T cells was increased in extremely severe patients. The IL-2R, IL-6, and IL-10 were all increased in extremely severe patients. The activation of DC and B cells was decreased in extremely severe patients.
CONCLUSIONS:

The number and function of T cells are inconsistent in COVID-19 patients. The hyperfunction of CD4+ and CD8+ T cells is associated with the pathogenesis of extremely severe SARS-CoV-2 infection.



KEYWORDS:

Adaptive immunity; Cellular immune response; Immunology; Infectious disease; Innate immunity


PMID:32324595DOI:10.1172/jci.insight.137799