Abstract
Background: COVID-19 is threating human health worldwide. We aim to investigate the dynamic changes of immune status in COVID-19 patients with clinical evolution.
Methods: Sixty-one COVID-19 patients (42 mild cases and 19 severe cases, 51 cases without secondary infection as non-infection group and 10 cases with secondary bacterial/fungal infection as infection group) and 52 healthy controls (HCs) were enrolled from our hospital. Leucocyte classification, lymphocyte subsets and cytokines were detected by full-automatic blood cell analyzer and flow cytometer, respectively.
Results: Upon admission, eosinophils and lymphocyte subsets decreased significantly, while neutrophils, monocytes, basophils, IL-2, IL-6, IL-10 and IFN-γ increased significantly in COVID-19 patients compared to HCs. CD3 + T and DN (CD3 + CD4 – CD8 – ) cells appeared sustained decline, leucocytes, neutrophils and IL-10 showed sustained increase in severe group compared to mild group. Compared with the non-infection group, we observed a depletion of eosinophils, CD3 + T and CD4 + T cells, but leucocytes, neutrophils, IL-6 and IL-10 on the contrary in the infection group. Besides, in severe group of COVID-19 patients, DN cells were negatively correlated with IL-10, and DP (CD3 + CD4 + CD8 + ) cells were negatively correlated with IL-6. Lymphocytes, eosinophils, CD3 + T cells, CD4 + T cells, IL-6 and IL-10 all had great diagnostic efficacy (AUC, 0.905-0.975) for COVID-19. The laboratory indicators of COVID-19 patients with improved condition also showed a recovery trend with time.
Conclusions: The immune status of COVID-19 patients is different in each stage, and dynamic monitoring of related indicators can help predict the disease and may avoid cytokine storms.
Keywords: COVID-19; Cytokines; Immune monitoring; Lymphocyte subsets.
【저자키워드】 COVID-19, Cytokines, Lymphocyte subsets, Immune monitoring, 【초록키워드】 Neutrophils, Monocytes, Efficacy, Cytokines, Lymphocytes, T cells, IL-6, hospital, neutrophil, Infection, diagnostic, Lymphocyte subsets, cytokine, CD4, CD8, eosinophil, Laboratory, lymphocyte, Health, Secondary infection, Lymphocyte subset, eosinophils, severe cases, Mild, IL-10, change, Admission, predict, COVID-19 patients, Blood, IFN-γ, IL-2, Immune status, basophils, COVID-19 patient, AUC, Cytokine storms, blood cell, healthy control, severe group, leucocytes, help, contrary, Depletion, clinical evolution, flow cytometer, CD3, Cell, enrolled, significantly, the disease, correlated, increase in, sustained, HCs, mild case, 【제목키워드】 COVID-19 patient, Continuous,