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Viral Immunol . Lymphocyte Subset Alteration and Monocyte CD4 Expression Reduction in Patients with Severe COVID-19

tetano

Editor, Senior Moderator
Viral Immunol


. 2020 Nov 23.
doi: 10.1089/vim.2020.0166. Online ahead of print.
Lymphocyte Subset Alteration and Monocyte CD4 Expression Reduction in Patients with Severe COVID-19


Sumeyye Kazancioglu[SUP] 1 [/SUP], Fatma Meric Yilmaz[SUP] 2 3 [/SUP], Aliye Bastug[SUP] 4 [/SUP], Arzu Sakallı[SUP] 2 [/SUP], Bahadır Orkun Ozbay[SUP] 1 [/SUP], Cansu Buyuktarakci[SUP] 1 [/SUP], Hurrem Bodur[SUP] 4 [/SUP], Gulsen Yilmaz[SUP] 2 3 [/SUP]



Affiliations

Abstract

The spectrum of coronavirus disease 2019 (COVID-19) severity, related to cellular immune functions, has not been fully clarified yet. Therefore, this study aimed to investigate the alteration of peripheral blood cells in patients with COVID-19. The flow cytometric characterization of immune cell subset was performed on 69 COVID-19 patients and 21 healthy controls. These data were evaluated based on the disease severity. A total of 69 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were classified as asymptomatic infection (n = 14), nonsevere (n = 39), and severe (n = 16) groups. Decreased lymphocytes and increased CD14 + 4- monocytes are found in patients with severe COVID-19. Decreased CD4 expression level was observed in the monocytes of patients with severe COVID-19. The total lymphocytes, B and T lymphocytes, CD4+ cells and CD8+ cells, and natural killer (NK) and natural killer T (NKT) cells were found to be decreased in patients with severe COVID-19. The CD4+/CD8+ ratio was not significantly different between patients with COVID-19 and healthy controls. The percentage of activated T cells (CD3+HLA-DR+) and B cells (CD19+CD38+) was lower in patients with severe COVID-19. Age and CD4- monocytes were independent predictors of disease severity. The SARS-CoV-2 infection may affect lymphocyte subsets, resulting in decreased T and B cells, monocytes, and NK and NKT cells. Decreased CD4 expression level by monocytes was significantly correlated with disease severity. Further studies on the host immune response to SARS-CoV-2 infection are necessary to predict the disease severity and protect against the virus.

Keywords: CD4; COVID-19; SARS-CoV-2; coronavirus; cytometry; lymphocyte; monocyte.
 
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