Immune dysfunction following COVID-19, especially in severe patients.
Identifieur interne : 000516 ( Main/Exploration ); précédent : 000515; suivant : 000517Immune dysfunction following COVID-19, especially in severe patients.
Auteurs : Cong-Ying Song [République populaire de Chine] ; Jia Xu [République populaire de Chine] ; Jian-Qin He [République populaire de Chine] ; Yuan-Qiang Lu [République populaire de Chine]Source :
- Scientific reports [ 2045-2322 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (immunologie), Cellules tueuses naturelles (immunologie), Femelle (MeSH), Granulocytes neutrophiles (immunologie), Humains (MeSH), Indice de gravité de la maladie (MeSH), Infections à coronavirus (anatomopathologie), Infections à coronavirus (immunologie), Lymphocytes B (immunologie), Lymphocytes T CD4+ (immunologie), Lymphocytes T CD8+ (immunologie), Mâle (MeSH), Numération des lymphocytes (MeSH), Pandémies (MeSH), Phénomènes du système immunitaire (physiologie), Pneumopathie virale (anatomopathologie), Pneumopathie virale (immunologie), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Études rétrospectives (MeSH).
- MESH :
- anatomopathologie : Infections à coronavirus, Pneumopathie virale.
- immunologie : Betacoronavirus, Cellules tueuses naturelles, Granulocytes neutrophiles, Infections à coronavirus, Lymphocytes B, Lymphocytes T CD4+, Lymphocytes T CD8+, Pneumopathie virale.
- physiologie : Phénomènes du système immunitaire.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Indice de gravité de la maladie, Mâle, Numération des lymphocytes, Pandémies, Résultat thérapeutique, Sujet âgé, Études rétrospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), B-Lymphocytes (immunology), Betacoronavirus (immunology), CD4-Positive T-Lymphocytes (immunology), CD8-Positive T-Lymphocytes (immunology), Coronavirus Infections (immunology), Coronavirus Infections (pathology), Female (MeSH), Humans (MeSH), Immune System Phenomena (physiology), Killer Cells, Natural (immunology), Lymphocyte Count (MeSH), Male (MeSH), Middle Aged (MeSH), Neutrophils (immunology), Pandemics (MeSH), Pneumonia, Viral (immunology), Pneumonia, Viral (pathology), Retrospective Studies (MeSH), Severity of Illness Index (MeSH), Treatment Outcome (MeSH).
- MESH :
- immunology : B-Lymphocytes, Betacoronavirus, CD4-Positive T-Lymphocytes, CD8-Positive T-Lymphocytes, Coronavirus Infections, Killer Cells, Natural, Neutrophils, Pneumonia, Viral.
- pathology : Coronavirus Infections, Pneumonia, Viral.
- physiology : Immune System Phenomena.
- Adult, Aged, Female, Humans, Lymphocyte Count, Male, Middle Aged, Pandemics, Retrospective Studies, Severity of Illness Index, Treatment Outcome.
Abstract
The coronavirus disease 2019 (COVID-19) has been spreading worldwide. Severe cases quickly progressed with unfavorable outcomes. We aim to investigate the clinical features of COVID-19 and identify the risk factors associated with its progression. Data of confirmed SARS-CoV-2-infected patients and healthy participants were collected. Thirty-seven healthy people and 79 confirmed patients, which include 48 severe patients and 31 mild patients, were recruited. COVID-19 patients presented with dysregulated immune response (decreased T, B, and NK cells and increased inflammatory cytokines). Also, they were found to have increased levels of white blood cell, neutrophil count, and D-dimer in severe cases. Moreover, lymphocyte, CD4+ T cell, CD8+ T cell, NK cell, and B cell counts were lower in the severe group. Multivariate logistic regression analysis showed that CD4+ cell count, neutrophil-to-lymphocyte ratio (NLR) and D-dimer were risk factors for severe cases. Both CT score and clinical pulmonary infection score (CPIS) were associated with disease severity. The receiver operating characteristic (ROC) curve analysis has shown that all these parameters and scores had quite a high predictive value. Immune dysfunction plays critical roles in disease progression. Early and constant surveillance of complete blood cell count, T lymphocyte subsets, coagulation function, CT scan and CPIS was recommended for early screening of severe cases.
DOI: 10.1038/s41598-020-72718-9
PubMed: 32985562
PubMed Central: PMC7522270
Affiliations:
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uniqKey="Song C" first="Cong-Ying" last="Song">Cong-Ying Song</name><affiliation wicri:level="4"><nlm:affiliation>Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang</wicri:regionArea><orgName type="university">Université de Zhejiang</orgName><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName></affiliation></author><author><name sortKey="Xu, Jia" sort="Xu, Jia" uniqKey="Xu J" first="Jia" last="Xu">Jia Xu</name><affiliation wicri:level="4"><nlm:affiliation>Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang</wicri:regionArea><orgName type="university">Université de Zhejiang</orgName><placeName><settlement type="city">Hangzhou</settlement><region 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type="province">Zhejiang</region></placeName></affiliation></author></analytic><series><title level="j">Scientific reports</title><idno type="eISSN">2045-2322</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>B-Lymphocytes (immunology)</term><term>Betacoronavirus (immunology)</term><term>CD4-Positive T-Lymphocytes (immunology)</term><term>CD8-Positive T-Lymphocytes (immunology)</term><term>Coronavirus Infections (immunology)</term><term>Coronavirus Infections (pathology)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Immune System Phenomena (physiology)</term><term>Killer Cells, Natural (immunology)</term><term>Lymphocyte Count (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Neutrophils (immunology)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (immunology)</term><term>Pneumonia, Viral (pathology)</term><term>Retrospective Studies (MeSH)</term><term>Severity of Illness Index (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Betacoronavirus (immunologie)</term><term>Cellules tueuses naturelles (immunologie)</term><term>Femelle (MeSH)</term><term>Granulocytes neutrophiles (immunologie)</term><term>Humains (MeSH)</term><term>Indice de gravité de la maladie (MeSH)</term><term>Infections à coronavirus (anatomopathologie)</term><term>Infections à coronavirus (immunologie)</term><term>Lymphocytes B (immunologie)</term><term>Lymphocytes T CD4+ (immunologie)</term><term>Lymphocytes T CD8+ (immunologie)</term><term>Mâle (MeSH)</term><term>Numération des lymphocytes (MeSH)</term><term>Pandémies (MeSH)</term><term>Phénomènes du système immunitaire (physiologie)</term><term>Pneumopathie virale (anatomopathologie)</term><term>Pneumopathie virale (immunologie)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Betacoronavirus</term><term>Cellules tueuses naturelles</term><term>Granulocytes neutrophiles</term><term>Infections à coronavirus</term><term>Lymphocytes B</term><term>Lymphocytes T CD4+</term><term>Lymphocytes T CD8+</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>B-Lymphocytes</term><term>Betacoronavirus</term><term>CD4-Positive T-Lymphocytes</term><term>CD8-Positive T-Lymphocytes</term><term>Coronavirus Infections</term><term>Killer Cells, Natural</term><term>Neutrophils</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Phénomènes du système immunitaire</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Immune System Phenomena</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Lymphocyte Count</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de gravité de la maladie</term><term>Mâle</term><term>Numération des lymphocytes</term><term>Pandémies</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The coronavirus disease 2019 (COVID-19) has been spreading worldwide. Severe cases quickly progressed with unfavorable outcomes. We aim to investigate the clinical features of COVID-19 and identify the risk factors associated with its progression. Data of confirmed SARS-CoV-2-infected patients and healthy participants were collected. Thirty-seven healthy people and 79 confirmed patients, which include 48 severe patients and 31 mild patients, were recruited. COVID-19 patients presented with dysregulated immune response (decreased T, B, and NK cells and increased inflammatory cytokines). Also, they were found to have increased levels of white blood cell, neutrophil count, and D-dimer in severe cases. Moreover, lymphocyte, CD4<sup>+</sup> T cell, CD8<sup>+</sup> T cell, NK cell, and B cell counts were lower in the severe group. Multivariate logistic regression analysis showed that CD4<sup>+</sup> cell count, neutrophil-to-lymphocyte ratio (NLR) and D-dimer were risk factors for severe cases. Both CT score and clinical pulmonary infection score (CPIS) were associated with disease severity. The receiver operating characteristic (ROC) curve analysis has shown that all these parameters and scores had quite a high predictive value. Immune dysfunction plays critical roles in disease progression. Early and constant surveillance of complete blood cell count, T lymphocyte subsets, coagulation function, CT scan and CPIS was recommended for early screening of severe cases.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32985562</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>13</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">2045-2322</ISSN><JournalIssue CitedMedium="Internet"><Volume>10</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>09</Month><Day>28</Day></PubDate></JournalIssue><Title>Scientific reports</Title><ISOAbbreviation>Sci Rep</ISOAbbreviation></Journal><ArticleTitle>Immune dysfunction following COVID-19, especially in severe patients.</ArticleTitle><Pagination><MedlinePgn>15838</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1038/s41598-020-72718-9</ELocationID><Abstract><AbstractText>The coronavirus disease 2019 (COVID-19) has been spreading worldwide. Severe cases quickly progressed with unfavorable outcomes. We aim to investigate the clinical features of COVID-19 and identify the risk factors associated with its progression. Data of confirmed SARS-CoV-2-infected patients and healthy participants were collected. Thirty-seven healthy people and 79 confirmed patients, which include 48 severe patients and 31 mild patients, were recruited. COVID-19 patients presented with dysregulated immune response (decreased T, B, and NK cells and increased inflammatory cytokines). Also, they were found to have increased levels of white blood cell, neutrophil count, and D-dimer in severe cases. Moreover, lymphocyte, CD4<sup>+</sup> T cell, CD8<sup>+</sup> T cell, NK cell, and B cell counts were lower in the severe group. Multivariate logistic regression analysis showed that CD4<sup>+</sup> cell count, neutrophil-to-lymphocyte ratio (NLR) and D-dimer were risk factors for severe cases. Both CT score and clinical pulmonary infection score (CPIS) were associated with disease severity. The receiver operating characteristic (ROC) curve analysis has shown that all these parameters and scores had quite a high predictive value. Immune dysfunction plays critical roles in disease progression. Early and constant surveillance of complete blood cell count, T lymphocyte subsets, coagulation function, CT scan and CPIS was recommended for early screening of severe cases.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Song</LastName><ForeName>Cong-Ying</ForeName><Initials>CY</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xu</LastName><ForeName>Jia</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>He</LastName><ForeName>Jian-Qin</ForeName><Initials>JQ</Initials><AffiliationInfo><Affiliation>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lu</LastName><ForeName>Yuan-Qiang</ForeName><Initials>YQ</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine and Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China. luyuanqiang@zju.edu.cn.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Sci Rep</MedlineTA><NlmUniqueID>101563288</NlmUniqueID><ISSNLinking>2045-2322</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001402" MajorTopicYN="N">B-Lymphocytes</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015496" MajorTopicYN="N">CD4-Positive T-Lymphocytes</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018414" MajorTopicYN="N">CD8-Positive T-Lymphocytes</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055633" MajorTopicYN="N">Immune System Phenomena</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007694" MajorTopicYN="N">Killer Cells, Natural</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018655" MajorTopicYN="N">Lymphocyte Count</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009504" MajorTopicYN="N">Neutrophils</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>09</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>28</Day><Hour>8</Hour><Minute>45</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32985562</ArticleId><ArticleId IdType="doi">10.1038/s41598-020-72718-9</ArticleId><ArticleId IdType="pii">10.1038/s41598-020-72718-9</ArticleId><ArticleId IdType="pmc">PMC7522270</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>J Clin Invest. 2020 Jun 1;130(6):2757-2765</Citation><ArticleIdList><ArticleId IdType="pubmed">32254064</ArticleId></ArticleIdList></Reference><Reference><Citation>J Zhejiang Univ Sci B. 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