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Scand J Immunol . Lymphopenia an important immunological abnormality in patients with COVID-19: Possible mechanisms

tetano

Editor, Senior Moderator
Scand J Immunol


. 2020 Sep 1;e12967.
doi: 10.1111/sji.12967. Online ahead of print.
Lymphopenia an important immunological abnormality in patients with COVID-19: Possible mechanisms


Abdollah Jafarzadeh[SUP] 1 2 [/SUP], Sara Jafarzadeh[SUP] 3 [/SUP], Parvin Nozari[SUP] 1 [/SUP], Pejman Mokhtari[SUP] 1 [/SUP], Maryam Nemati[SUP] 4 5 [/SUP]



Affiliations

Abstract

The lymphopenia as a major immunological abnormality occurs in the majority of severe COVID-19 patients, which is strongly associated mortality rate. A low proportion of lymphocytes may express the main receptor for SARS-CoV-2, called angiotensin-converting enzyme 2 (ACE2). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can also use ACE2-independent pathways to enter lymphocytes. Both SARS-CoV-2- and immune-mediated mechanisms may contribute to the occurrence of lymphopenia through influencing the lymphocyte production, survival, or tissue re-distribution. The metabolic and biochemical changes can also affect the production and survival of lymphocytes in COVID-19 patients. Lymphopenia can cause general immunosuppression and promote cytokine storm, both of them play an important role in the viral persistence, viral replication, multi-organ failure and eventually death. Here, a comprehensive view concerning the possible mechanisms that may lead to the lymphocyte reduction in COVID-19 patients is provided, while highlighting the potential intervention approaches to prevent lymphopenia.

Keywords: COVID-19, SARS-CoV-2; Lymphocytes; Lymphopenia.
 
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