Background The current outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses an unprecedented health crisis. The most common chronic illness among patients infected with SARS-CoV-2 is hypertension. Immune dysregulation plays an important role in SARS-CoV-2 infection and in the development of hypertension; however, the dynamic immunological characteristics of COVID-19 patients with hypertension remain largely unclear. Methods In total, 258 hypertensive patients infected with SARS-CoV-2 were included in this study. CD38 + HLA-DR + and CD38 + PD-1 + CD8 + T cells, IFNγ + CD4 + and IFNγ + CD8 + T cells, the titers of IgG, IgM, and IgA against SARS-CoV-2 spike protein, and SARS-CoV-2 throat viral loads were measured weekly over 4 weeks after the onset of symptoms. Clinical outcomes were also monitored. Findings CD4 + T lymphopenia was observed in 100% of the severe and critical cases. Compared with the surviving patients, the patients with fatal outcomes exhibited high and prolonged expression of CD38 + HLA-DR + and CD38 + PD-1 + on CD8 + T cells, low expression of SARS-CoV-2-specific IFNγ + CD4 + and IFNγ + CD8 + T cells, low titers of IgG, IgM, and IgA against SARS-CoV-2 spike protein, and high SARS-CoV-2 viral load during the illness. In the surviving patients, the viral load was significantly inversely correlated with SARS-CoV-2-specific IFNγ + CD8 + and IFNγ + CD4 + T cells, IgG, IgM, and IgA. Interpretation T lymphopenia is common in critical or severe COVID-19 cases with hypertension. Prolonged activation and exhaustion of CD8 + T cells were associated with severe disease. The delayed SARS-CoV-2-specific antibody responses may be insufficient for overcoming severe SARS-CoV-2 infection in the absence of SARS-CoV-2-specific cellular responses.
【저자키워드】 COVID-19, SARS-CoV-2, CD4, CD8, hypertension, T cell, 【초록키워드】 coronavirus disease, IgG, IgM, coronavirus, severe COVID-19, T cells, SARS-COV-2 infection, Antibody Response, Infection, outcome, lymphopenia, Health, Viral load, outbreak, IgA, clinical, SARS-CoV-2 spike protein, Patient, expression, Critical, HLA-DR, CD38, Prolonged, severe disease, COVID-19 patient, critical cases, Cellular responses, dysregulation, Chronic illness, acute respiratory syndrome, Activation, SARS-CoV-2 viral load, IFNγ, low expression, surviving patients, finding, immunological characteristics, severe SARS-CoV-2, caused, significantly, the patient, exhibited, absence, correlated, onset of symptoms, were measured, hypertensive patient, infected with SARS-CoV-2, titers of IgG, 【제목키워드】 hypertension, dynamic, Ill,