Department of Clinical Microbiology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China.
Department of Respiratory Medicine, and The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China.
Viral Immunol. 2021 Jun;34(5):330-335. doi: 10.1089/vim.2020.0062. Epub 2020 Apr 10.
The aim of this study was to analyze the correlation between dynamic changes in the nasopharyngeal viral load of patients infected with the new coronavirus causing pneumonia and lymphocyte count disease severity. Cases newly diagnosed with COVID-19 at the First Affiliated Hospital of Nanchang University from January 2020 to February 2020 were analyzed retrospectively. Quantitative real-time polymerase chain reaction was used to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from throat swab sample ΔCT values; lymphocyte and lymphocyte subset counts, coagulation system factor levels, myocardial injury indexes, and laboratory biochemical indicators were compared between the mild group and the severe group. The correlation between the relative load of nasopharyngeal SARS-CoV-2 RNA and severe disease symptoms was analyzed. Of the 76 patients, 49 were male and 27 were female. The lymphocyte, CD4 T lymphocyte, and CD8 T lymphocyte counts all differed significantly between the two groups ( < 0.001), as did differences in interleukin (IL)-2R, IL-6, and IL-8 levels ( = 0.022, 0.026, and 0.012, respectively). Moreover, there were significant differences in prothrombin time, D-dimer, and fibrinogen levels between the mild group and the severe group ( = 0.029, 0.006, and <0.001, respectively), and in lactate dehydrogenase and troponin ( < 0.001 and = 0.007, respectively). SARS-CoV-2 RNA load and lymphocyte count, CD4 T lymphocyte count, and CD8 T lymphocyte count were linearly negatively correlated ( < 0.001). SARS-CoV-2 RNA load was positively correlated with IL-2R, prothrombin time, lactate dehydrogenase, and hypersensitive troponin T ( = 0.002, = 0.009, and < 0.001, respectively). In addition, the time that it took for the nucleic acid test to turn negative was significantly shorter for patients in the mild group than for those in the severe group ( = -6.713, < 0.001). In conclusion, relative SARS-CoV-2 RNA load in the nasopharynx is closely related to COVID-19 severity. If the relative RNA load was higher, the lymphocyte count was lower, organ damage was greater, and the time it took for the nucleic acid test to turn negative was longer.
本研究旨在分析感染新型冠状病毒肺炎患者鼻咽病毒载量的动态变化与淋巴细胞计数、疾病严重程度的相关性。对 2020 年 1 月至 2 月南昌大学第一附属医院新诊断的 COVID-19 病例进行回顾性分析。采用实时荧光定量聚合酶链反应（qRT-PCR）检测咽拭子样本中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的ΔCT 值；比较轻、重症组淋巴细胞、淋巴细胞亚群计数、凝血系统因子水平、心肌损伤指标和实验室生化指标；分析鼻咽 SARS-CoV-2 RNA 相对负荷与严重疾病症状的相关性。76 例患者中，男 49 例，女 27 例。两组间淋巴细胞、CD4+T 淋巴细胞、CD8+T 淋巴细胞计数差异均有统计学意义（ < 0.001），白细胞介素（IL）-2R、IL-6、IL-8 水平差异亦有统计学意义（ = 0.022、0.026、0.012）。此外，两组间凝血酶原时间、D-二聚体、纤维蛋白原水平差异均有统计学意义（ = 0.029、0.006、<0.001），乳酸脱氢酶、肌钙蛋白差异亦有统计学意义（ < 0.001、 = 0.007）。SARS-CoV-2 RNA 载量与淋巴细胞计数、CD4+T 淋巴细胞计数、CD8+T 淋巴细胞计数呈线性负相关（ < 0.001）。SARS-CoV-2 RNA 载量与 IL-2R、凝血酶原时间、乳酸脱氢酶、超敏肌钙蛋白 T 呈正相关（ = 0.002、 = 0.009、 < 0.001）。此外，核酸检测转阴时间在轻症组明显短于重症组（ = -6.713、 < 0.001）。结论：鼻咽部相对 SARS-CoV-2 RNA 载量与 COVID-19 严重程度密切相关。相对 RNA 载量越高，淋巴细胞计数越低，器官损伤越大，核酸检测转阴时间越长。
