tetano
Editor, Senior Moderator
Life Sci
. 2020 Jul 28;118167.
doi: 10.1016/j.lfs.2020.118167. Online ahead of print.
The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis
Hamed Akbari[SUP] 1 [/SUP], Reza Tabrizi[SUP] 2 [/SUP], Kamran B Lankarani[SUP] 2 [/SUP], Hamid Aria[SUP] 3 [/SUP], Sina Vakili[SUP] 4 [/SUP], Fatemeh Asadian[SUP] 5 [/SUP], Saam Noroozi[SUP] 6 [/SUP], Pedram Keshavarz[SUP] 7 [/SUP], Sanaz Faramarz[SUP] 8 [/SUP]
Affiliations
Abstract
Aims: This study aimed to make a comparison between the clinical laboratory-related factors, complete blood count (CBC) indices, cytokines, and lymphocyte subsets in order to distinguish severe coronavirus disease 2019 (COVID-19) cases from the non-severe ones.
Materials and methods: Relevant studies were searched in PubMed, Embase, Scopus, and Web of Science databases until March 31, 2020. Cochrane's Q test and the I[SUP]2[/SUP] statistic were used to determine heterogeneity. We used the random-effect models to pool the weighted mean differences (WMDs) and 95% confidence intervals (CIs).
Key findings: Out of a total of 8557 initial records, 44 articles (50 studies) with 7865 patients (ranging from 13 to 1582), were included. Our meta-analyses with random-effect models showed a significant decrease in lymphocytes, monocyte, CD4+ T cells, CD8+ T cells, CD3 cells, CD19 cells, and natural killer (NK) cells and an increase in the white blood cell (WBC), neutrophils, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP)/hs-CRP, erythrocyte sedimentation rate (ESR), ferritin, procalcitonin (PCT), and serum amyloid A (SAA), interleukin-2 (IL-2), IL-2R, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (INF-γ) in the severe group compared to the non-severe group. However, no significant differences were found in IL-1β, IL-17, and CD4/CD8 T cell ratio between the two groups.
Significance: Decrease in total lymphocytes and lymphocyte subsets as well as the elevation of CRP, ESR, SAA, PCT, ferritin, and cytokines, but not IL-1β and IL-17, were closely associated with COVID-19 severity, implying reliable indicators of severe COVID-19.
Keywords: COVID-19; Cytokine; Laboratory findings; Lymphocyte subsets; Meta-analysis; Novel coronavirus; SARS-CoV-2.
. 2020 Jul 28;118167.
doi: 10.1016/j.lfs.2020.118167. Online ahead of print.
The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis
Hamed Akbari[SUP] 1 [/SUP], Reza Tabrizi[SUP] 2 [/SUP], Kamran B Lankarani[SUP] 2 [/SUP], Hamid Aria[SUP] 3 [/SUP], Sina Vakili[SUP] 4 [/SUP], Fatemeh Asadian[SUP] 5 [/SUP], Saam Noroozi[SUP] 6 [/SUP], Pedram Keshavarz[SUP] 7 [/SUP], Sanaz Faramarz[SUP] 8 [/SUP]
Affiliations
- PMID: 32735885
- DOI: 10.1016/j.lfs.2020.118167
Abstract
Aims: This study aimed to make a comparison between the clinical laboratory-related factors, complete blood count (CBC) indices, cytokines, and lymphocyte subsets in order to distinguish severe coronavirus disease 2019 (COVID-19) cases from the non-severe ones.
Materials and methods: Relevant studies were searched in PubMed, Embase, Scopus, and Web of Science databases until March 31, 2020. Cochrane's Q test and the I[SUP]2[/SUP] statistic were used to determine heterogeneity. We used the random-effect models to pool the weighted mean differences (WMDs) and 95% confidence intervals (CIs).
Key findings: Out of a total of 8557 initial records, 44 articles (50 studies) with 7865 patients (ranging from 13 to 1582), were included. Our meta-analyses with random-effect models showed a significant decrease in lymphocytes, monocyte, CD4+ T cells, CD8+ T cells, CD3 cells, CD19 cells, and natural killer (NK) cells and an increase in the white blood cell (WBC), neutrophils, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP)/hs-CRP, erythrocyte sedimentation rate (ESR), ferritin, procalcitonin (PCT), and serum amyloid A (SAA), interleukin-2 (IL-2), IL-2R, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (INF-γ) in the severe group compared to the non-severe group. However, no significant differences were found in IL-1β, IL-17, and CD4/CD8 T cell ratio between the two groups.
Significance: Decrease in total lymphocytes and lymphocyte subsets as well as the elevation of CRP, ESR, SAA, PCT, ferritin, and cytokines, but not IL-1β and IL-17, were closely associated with COVID-19 severity, implying reliable indicators of severe COVID-19.
Keywords: COVID-19; Cytokine; Laboratory findings; Lymphocyte subsets; Meta-analysis; Novel coronavirus; SARS-CoV-2.