The dysregulation of both the innate and adaptive responses to SARS-CoV-2 have an impact on the course of COVID-19, and play a role in the clinical outcome of the disease. Here, we performed a comprehensive analysis of peripheral blood lymphocyte subpopulations in 82 patients with COVID-19, including 31 patients with a critical course of the disease. In COVID-19 patients who required hospitalization we analyzed T cell subsets, including Treg cells, as well as TCRα/β and γ/δ, NK cells, and B cells, during the first two weeks after admission to hospital due to the SARS-CoV-2 infection, with marked reductions in leukocytes subpopulations, especially in critically ill COVID-19 patients. We showed decreased levels of Th, Ts cells, Treg cells (both naïve and induced), TCRα/β and γ/δ cells, as well as CD16+CD56+NK cells in ICU compared to non-ICU COVID-19 patients. We observed impaired function of T and NK cells in critically ill COVID-19 patients with extremely low levels of secreted cytokines. We found that the IL-2/INFγ ratio was the strongest indicator of a critical course of COVID-19, and was associated with fatal outcomes. Our findings showed markedly impaired innate and adaptive responses in critically ill COVID-19 patients, and suggest that the immunosuppressive state in the case of a critical course of SARS-CoV-2 infection might reflect subsequent clinical deterioration and predict a fatal outcome.
【저자키워드】 COVID-19, T cells, NK cells, Immunosuppression, TNFα, Lymphocyte subsets, regulatory T cells, IL-2, TCR γ/δ cells, TCRα/β, INFγ, IL-2/INFγ ratio, 【초록키워드】 SARS-CoV-2, Cytokines, adaptive, Hospitalization, SARS-COV-2 infection, hospital, Infection, B cells, NK cell, outcome, ICU, Peripheral blood, Clinical outcome, outcomes, T cell, Critically ill, cells, response, Patient, Admission, Critical, predict, COVID-19 patients, immunosuppressive, COVID-19 patient, Clinical deterioration, dysregulation, leukocyte, comprehensive analysis, non-ICU, naïve, impaired function, Treg cells, subpopulations, Cell, Course, analyzed, performed, subsequent, the disease, required, reductions in, lymphocyte subpopulation, patients with COVID-19, secreted, the SARS-CoV-2, Treg cell, 【제목키워드】 Prospective,