Clinical and immunological features of severe and moderate coronavirus disease 2019
- PMID: 32217835
- PMCID: PMC7190990
- DOI: 10.1172/JCI137244
Clinical and immunological features of severe and moderate coronavirus disease 2019
Abstract
BACKGROUNDSince December 2019, an outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, and is now becoming a global threat. We aimed to delineate and compare the immunological features of severe and moderate COVID-19.METHODSIn this retrospective study, the clinical and immunological characteristics of 21 patients (17 male and 4 female) with COVID-19 were analyzed. These patients were classified as severe (11 cases) and moderate (10 cases) according to the guidelines released by the National Health Commission of China.RESULTSThe median age of severe and moderate cases was 61.0 and 52.0 years, respectively. Common clinical manifestations included fever, cough, and fatigue. Compared with moderate cases, severe cases more frequently had dyspnea, lymphopenia, and hypoalbuminemia, with higher levels of alanine aminotransferase, lactate dehydrogenase, C-reactive protein, ferritin, and D-dimer as well as markedly higher levels of IL-2R, IL-6, IL-10, and TNF-α. Absolute numbers of T lymphocytes, CD4+ T cells, and CD8+ T cells decreased in nearly all the patients, and were markedly lower in severe cases (294.0, 177.5, and 89.0 × 106/L, respectively) than moderate cases (640.5, 381.5, and 254.0 × 106/L, respectively). The expression of IFN-γ by CD4+ T cells tended to be lower in severe cases (14.1%) than in moderate cases (22.8%).CONCLUSIONThe SARS-CoV-2 infection may affect primarily T lymphocytes, particularly CD4+ and CD8+ T cells, resulting in a decrease in numbers as well as IFN-γ production by CD4+ T cells. These potential immunological markers may be of importance because of their correlation with disease severity in COVID-19.TRIAL REGISTRATIONThis is a retrospective observational study without a trial registration number.FUNDINGThis work is funded by grants from Tongji Hospital for the Pilot Scheme Project, and partly supported by the Chinese National Thirteenth Five Years Project in Science and Technology for Infectious Disease (2017ZX10202201).
Keywords: COVID-19; Cytokines; Immunology; Infectious disease; Respiration; T cells.
Conflict of interest statement
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7190990/bin/jci-130-137244-g326.gif)
![Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7190990/bin/jci-130-137244-g327.gif)
![Figure 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7190990/bin/jci-130-137244-g328.gif)
Comment in
-
Studying smoking benefit in farmer's lung to understand Covid-19.Occup Med (Lond). 2020 Dec 30;70(9):620-621. doi: 10.1093/occmed/kqaa147. Occup Med (Lond). 2020. PMID: 32779722 Free PMC article. No abstract available.
Similar articles
-
Regulation of the expression of proinflammatory cytokines induced by SARS-CoV-2.World J Clin Cases. 2021 Mar 6;9(7):1513-1523. doi: 10.12998/wjcc.v9.i7.1513. World J Clin Cases. 2021. PMID: 33728295 Free PMC article. Review.
-
High levels of SARS-CoV-2-specific T cells with restricted functionality in severe courses of COVID-19.JCI Insight. 2020 Oct 15;5(20):e142167. doi: 10.1172/jci.insight.142167. JCI Insight. 2020. PMID: 32937615 Free PMC article.
-
Hematological findings in coronavirus disease 2019: indications of progression of disease.Ann Hematol. 2020 Jul;99(7):1421-1428. doi: 10.1007/s00277-020-04103-5. Epub 2020 Jun 3. Ann Hematol. 2020. PMID: 32495027 Free PMC article. Review.
-
Clinical and Immune Features of Hospitalized Pediatric Patients With Coronavirus Disease 2019 (COVID-19) in Wuhan, China.JAMA Netw Open. 2020 Jun 1;3(6):e2010895. doi: 10.1001/jamanetworkopen.2020.10895. JAMA Netw Open. 2020. PMID: 32492165 Free PMC article.
-
The laboratory tests and host immunity of COVID-19 patients with different severity of illness.JCI Insight. 2020 May 21;5(10):e137799. doi: 10.1172/jci.insight.137799. JCI Insight. 2020. PMID: 32324595 Free PMC article.
Cited by
-
Diabetes and Infectious Diseases with a Focus on Melioidosis.Curr Microbiol. 2024 Jun 4;81(7):208. doi: 10.1007/s00284-024-03748-z. Curr Microbiol. 2024. PMID: 38833191 Review.
-
Development and validation of a prognostic model for assessing long COVID risk following Omicron wave-a large population-based cohort study.Virol J. 2024 May 31;21(1):123. doi: 10.1186/s12985-024-02400-3. Virol J. 2024. PMID: 38822405 Free PMC article.
-
Alterations in B and NK cells highly correlate with disease severity in children with COVID-19.Turk J Med Sci. 2023 Aug 10;53(5):1205-1213. doi: 10.55730/1300-0144.5686. eCollection 2023. Turk J Med Sci. 2023. PMID: 38813014 Free PMC article.
-
Intravenous high-dose anakinra drops venous thrombosis and acute coronary syndrome in severe and critical COVID-19 patients: a propensity score matched study.Sci Rep. 2024 May 29;14(1):12369. doi: 10.1038/s41598-024-62079-y. Sci Rep. 2024. PMID: 38811592 Free PMC article.
-
Evaluation of Biochemical Characteristics in a Retrospective Cohort of COVID-19 Patients.Cureus. 2024 Apr 24;16(4):e58889. doi: 10.7759/cureus.58889. eCollection 2024 Apr. Cureus. 2024. PMID: 38800147 Free PMC article.
References
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Research Materials
Miscellaneous