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. 2020 May 21;5(10):e137799.
doi: 10.1172/jci.insight.137799.

The laboratory tests and host immunity of COVID-19 patients with different severity of illness

Feng Wang  1 , Hongyan Hou  1 , Ying Luo  1 , Guoxing Tang  1 , Shiji Wu  1 , Min Huang  1 , Weiyong Liu  1 , Yaowu Zhu  1 , Qun Lin  1 , Liyan Mao  1 , Minghao Fang  2 , Huilan Zhang  3 , Ziyong Sun  1
Affiliations

The laboratory tests and host immunity of COVID-19 patients with different severity of illness

Feng Wang et al. JCI Insight. .

Abstract

BACKGROUNDThe coronavirus disease 2019 (COVID-19), infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a severe outbreak throughout the world. The host immunity of COVID-19 patients is unknown.METHODSThe routine laboratory tests and host immunity in COVID-19 patients with different severity of illness were compared after patient admission.RESULTSA total of 65 SARS-CoV-2-positive patients were classified as having mild (n = 30), severe (n = 20), and extremely severe (n = 15) illness. Many routine laboratory tests, such as ferritin, lactate dehydrogenase, and D-dimer, were increased in severe and extremely severe patients. The absolute numbers of CD4+ T cells, CD8+ T cells, and B cells were gradually decreased with increased severity of illness. The activation markers such as HLA-DR and CD45RO expressed on CD4+ and CD8+ T cells were increased in severe and extremely severe patients compared with mild patients. The costimulatory molecule CD28 had opposite results. The percentage of natural Tregs was decreased in extremely severe patients. The percentage of IFN-γ-producing CD8+ T cells was increased in both severe and extremely severe patients compared with mild patients. The percentage of IFN-γ-producing CD4+ T cells was increased in extremely severe patients. IL-2R, IL-6, and IL-10 were all increased in extremely severe patients. The activation of DC and B cells was decreased in extremely severe patients.CONCLUSIONThe number and function of T cells are inconsistent in COVID-19 patients. The hyperfunction of CD4+ and CD8+ T cells is associated with the pathogenesis of extremely severe SARS-CoV-2 infection.FUNDINGThis work was funded by the National Mega Project on Major Infectious Disease Prevention (2017ZX10103005-007) and the Fundamental Research Funds for the Central Universities (2019kfyRCPY098).

Keywords: Adaptive immunity; Cellular immune response; Immunology; Infectious disease; Innate immunity.

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Conflict of interest statement

Conflict of interest: The authors have declared that no conflict of interest exists.

Figures

Figure 1
Figure 1. TBNK lymphocyte counting.
The percentages and absolute numbers of T cells, B cells, and NK cells, and the results of CD4/CD8 ratio in different groups are shown in graphs (mean ± SD). *P < 0.05, **P < 0.01, ***P < 0.001 (1-way ANOVA).
Figure 2
Figure 2. The phenotypes and subsets of T cells.
(A–E) FACS dot plots showing the expression of HLA-DR (A), CD28 (B), PD-1 (C), Tim-3 (D) on CD4+ and CD8+ T cells, and the expression of CD45RA and CD45RO (E) on CD4+ T cells in representative patients with different severity of illness. (F) FACS dot plots showing the gating of Tregs, and the expression of CD45RA and CD45RO on Tregs in representative patients with different severity of illness. (G) The percentages of HLA-DR+, CD28+, PD-1+, and Tim-3+ cells in CD4+ or CD8+ T cells, the percentage of CD45RO+ cells in CD4+ T cells, the percentage of Tregs in lymphocytes, and the percentage of CD45RA+ Tregs in lymphocytes in patients with different groups are shown in graphs (mean ± SD). *P < 0.05, **P < 0.01, ***P < 0.001 (1-way ANOVA).
Figure 3
Figure 3. The IFN-γ–producing ability of CD4+ T cells, CD8+ T cells, and NK cells.
PMA/ionomycin-stimulated lymphocyte function assay was performed in patients with different severity of illness. (A) FACS dot plots showing the producing of IFN-γ in CD4+ T cells, CD8+ T cells, and NK cells in representative patients with different severity of illness after stimulation. (B) The percentages of IFN-γ+ cells in CD4+ T cells, CD8+ T cells, and NK cells, and the absolute numbers of IFN-γ producing CD4+ T cells, CD8+ T cells, and NK cells are shown in graphs (mean ± SD). ***P < 0.001 (1-way ANOVA).
Figure 4
Figure 4. Cytokine profile analysis.
The serum levels of IL-1β, IL-2R, IL-6, IL-8, IL-10, and TNF-α in different groups are shown in graphs (mean ± SD). *P < 0.05, **P < 0.01 (1-way ANOVA).
Figure 5
Figure 5. DC and B cell subsets.
(A) FACS dot plots showing the gating of DC and the expression of CD86 on DC in representative patients with different severity of illness. (B) FACS dot plots showing the expression of CD27 and CD86 on CD19+ B cells in representative patients with different severity of illness. (C) The percentages of DC in lymphocytes, CD86+ cells in DC, and CD27+ and CD86+ cells in B cells in different groups are shown in graphs (mean ± SD). *P < 0.05 (1-way ANOVA).
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References

    1. Zhu N, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed
    1. Chan JF, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect. 2020;9(1):221–236. doi: 10.1080/22221751.2020.1719902. - DOI - PMC - PubMed
    1. The Lancet Emerging understandings of 2019-nCoV. Lancet. 2020;395(10221):311. doi: 10.1016/S0140-6736(20)30186-0. - DOI - PMC - PubMed
    1. Bassetti M, Vena A, Giacobbe DR. The novel Chinese coronavirus (2019-nCoV) infections: Challenges for fighting the storm. Eur J Clin Invest. 2020;50(3):e13209. - PMC - PubMed
    1. Rothe C, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020;382(10):970–971. doi: 10.1056/NEJMc2001468. - DOI - PMC - PubMed

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