Dysregulation of immune response in patients with COVID-19 in Wuhan, China

By C. Qin, Luo-Qi Zhou, Zi-Wei Hu, Shuoqi Zhang, Sheng Yang, Yu Tao, Cuihong Xie, K. Ma, Ke Shang, Wei Wang and 1 more. Clinical Infectious Diseases, 2020

3,979 citations recorded by the source corpus.

Abstract Background In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China. Methods Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from January 10 to February 12, 2020, were collected and analyzed. The data of laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between severe and non-severe patients. Results Of the 452 patients with COVID-19 recruited, 286 were diagnosed as severe infection. The median age was 58 years and 235 were male. The most common symptoms were fever, shortness of breath, expectoration, fatigue, dry cough and myalgia. Severe cases tend to have lower lymphocytes counts, higher leukocytes counts and neutrophil-lymphocyte-ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most of severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines. The number of T cells significantly decreased, and more hampered in severe cases. Both helper T cells and suppressor T cells in patients with COVID-19 were below normal levels, and lower level of helper T cells in severe group. The percentage of naïve helper T cells increased and memory helper T cells decreased in severe cases. Patients with COVID-19 also have lower level of regulatory T cells, and more obviously damaged in severe cases. Conclusions The novel coronavirus might mainly act on lymphocytes, especially T lymphocytes. Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis and treatment of COVID-19.

Subfields: Immunology, Infectious Diseases, Neurology

View Paper: https://www.semanticscholar.org/paper/bb3b05f39611f48956bea87a419f7c9ffbf3a1fe

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Citations in the corpus

Exosomes Derived from Bone Marrow Mesenchymal Stem Cells as Treatment for Severe COVID-19 (2020, positive): “Central to COVID-19 disease progression is the development of cytokine storm, which is thought to be sustained and amplified by evolving parallel processes: (1) the activation of macrophages and other antigen presenting cells, alerting lymphocytes to the presence of the virus, (2) viral RNA replicat”
Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression (2020, neutral): “[3, 8, [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] 9, [27] [28] [29] [30] [31] [32] [33] [34] [35] [36] [10] [11] [12] [13] [14] [15] [16] There were a total of 6452 patients from 30 studies.”
COVID-19 and the human innate immune system (2021, background): “An increase in circulating neutrophils versus a decrease in lymphocytes has been appreciated as a hallmark of severe COVID-19 (Hadjadj et al., 2020; Mathew et al., 2020; Qin et al., 2020; Schulte-Schrepping et al., 2020).”
Aging in COVID-19: Vulnerability, immunity and intervention (2020, positive): “…lymphopenia and high neutrophil-lymphocyte ratio (NLR) are considered as useful predictors for COVID-19 death whereas high lymphocyte counts predict better clinical outcomes (Chen et al., 2020; Lagunas-Rangel and Chavez-Valencia, 2020; Qin et al., 2020; Wang et al., 2020a; Zhou et al., 2020a).”
Neutrophil to Lymphocyte Ratio: An Emerging Marker of the Relationships between the Immune System and Diseases (2022, background): “, procalcitonin, serum ferritin and CRP) than patients with mild-to-moderate COVID-19 disease [32].”
Immune Response, Inflammation, and the Clinical Spectrum of COVID-19 (2020, background): “Also, in severe COVID-19 the number of circulating naive T cells increases and the number of memory T cells decreases (106).”
Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis (2020, neutral): “Qu et al. 2020 [13] NR NR 3/30 (10%), severe 1010 (450) 1160 (550) NR NR NR Qin et al. 2020 [14] 1.5 2.6 286/452 (63%), severe 1000 (700–1300) 800 (600–1100) NR NR NR Wang et al. 2020 [15] 23.6 5.4 38/110 (34%), severe 1210 (530) 600 (310) NR NR NR Feng et al. 2020 [16] 4.9 2.8 15/141 (10%), severe…”
The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China (2020, background): “Immunohistochemical staining showed that CD4 + T cells and CD8 + T cells were decreased in spleen and lymph nodes [13] .”
SARS-CoV-2 infection: The role of cytokines in COVID-19 disease (2020, positive): “A study of 452 patients infected with SARS-CoV-2 also reported that the elevation of IL-6 levels was more marked with more severe symptoms [57].”