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J Immunol . The Inflammatory Factors Associated with Disease Severity to Predict COVID-19 Progression

tetano

Editor, Senior Moderator
J Immunol


. 2021 Feb 12;ji2001327.
doi: 10.4049/jimmunol.2001327. Online ahead of print.
The Inflammatory Factors Associated with Disease Severity to Predict COVID-19 Progression


Wei Huang[SUP] 1 [/SUP], Mei Li[SUP] 1 [/SUP], Guangwei Luo[SUP] 2 [/SUP], Xiaojie Wu[SUP] 2 [/SUP], Bintao Su[SUP] 1 [/SUP], Lan Zhao[SUP] 1 [/SUP], Shuang Zhang[SUP] 1 [/SUP], Xiaofan Chen[SUP] 1 [/SUP], Min Jia[SUP] 1 [/SUP], Jianhua Zhu[SUP] 1 [/SUP], Wen Su[SUP] 3 [/SUP], Dongxin Zhang[SUP] 4 [/SUP]



Affiliations

Abstract

Coronavirus disease 2019 (COVID-19) is associated with immune dysregulation and cytokine storm. Exploring the immune-inflammatory characteristics of COVID-19 patients is essential to reveal pathogenesis and predict progression. In this study, COVID-19 patients showed decreased CD3[SUP]+[/SUP], CD4[SUP]+[/SUP], and CD8[SUP]+[/SUP] T cells but increased neutrophils in circulation, exhibiting upregulated neutrophil-to-lymphocyte and neutrophil-to-CD8[SUP]+[/SUP] T cell ratio. IL-6, TNF-α, IL-1β, IL-18, IL-12/IL-23p40, IL-10, Tim-3, IL-8, neutrophil extracellular trap-related proteinase 3, and S100A8/A9 were elevated, whereas IFN-γ and C-type lectin domain family 9 member A (clec9A) were decreased in COVID-19 patients compared with healthy controls. When compared with influenza patients, the expressions of TNF-α, IL-18, IL-12/IL-23p40, IL-8, S100A8/A9 and Tim-3 were significantly increased in critical COVID-19 patients, and carcinoembryonic Ag, IL-8, and S100A8/A9 could serve as clinically available hematologic indexes for identifying COVID-19 from influenza. Moreover, IL-6, IL-8, IL-1β, TNF-α, proteinase 3, and S100A8/A9 were increased in bronchoalveolar lavage fluid of severe/critical patients compared with moderate patients, despite decreased CD4[SUP]+[/SUP] T cells, CD8[SUP]+[/SUP] T cells, B cells, and NK cells. Interestingly, bronchoalveolar IL-6, carcinoembryonic Ag, IL-8, S100A8/A9, and proteinase 3 were found to be predictive of COVID-19 severity and may serve as potential biomarkers for predicting COVID-19 progression and potential targets in therapeutic intervention of COVID-19.
 
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