Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Intensive Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Clin Transl Sci. 2020 Nov;13(6):1077-1086. doi: 10.1111/cts.12805. Epub 2020 May 14.
In this study we report on the clinical and autoimmune characteristics of severe and critical novel coronavirus pneumonia caused by severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2). The clinical, autoimmune, and laboratory characteristics of 21 patients who had laboratory-confirmed severe and critical cases of coronavirus disease 2019 (COVID-19) from the intensive care unit of the Huangshi Central Hospital, Hubei Province, China, were investigated. A total of 21 patients (13 men and 8 women), including 8 (38.1%) severe cases and 13 (61.9%) critical cases, were enrolled. Cough (90.5%) and fever (81.0%) were the dominant symptoms, and most patients (76.2%) had at least one coexisting disorder on admission. The most common characteristics on chest computed tomography were ground-glass opacity (100%) and bilateral patchy shadowing (76.2%). The most common findings on laboratory measurement were lymphocytopenia (85.7%) and elevated levels of C-reactive protein (94.7%) and interleukin-6 (89.5%). The prevalence of anti-52 kDa SSA/Ro antibody, anti-60 kDa SSA/Ro antibody, and antinuclear antibody was 20%, 25%, and 50%, respectively. We also retrospectively analyzed the clinical and laboratory data from 21 severe and critical cases of COVID-19. Autoimmune phenomena exist in COVID-19 subjects, and the present results provide the rationale for a strategy of preventing immune dysfunction and optimal immunosuppressive therapy.
本研究报告了严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的新型冠状病毒肺炎（COVID-19）重症和危重症患者的临床和自身免疫特征。研究人员调查了来自中国湖北省黄石市中心医院重症监护病房的 21 例经实验室确诊的 COVID-19 重症和危重症患者的临床、自身免疫和实验室特征。共纳入 21 例患者（男 13 例，女 8 例），其中重症 8 例（38.1%），危重症 13 例（61.9%）。咳嗽（90.5%）和发热（81.0%）是主要症状，大多数患者（76.2%）入院时至少合并一种并存疾病。胸部计算机断层扫描最常见的特征是磨玻璃样混浊（100%）和双侧斑片状阴影（76.2%）。实验室检测最常见的发现是淋巴细胞减少症（85.7%）、C 反应蛋白（94.7%）和白细胞介素 6（89.5%）水平升高。抗 52 kDa SSA/Ro 抗体、抗 60 kDa SSA/Ro 抗体和抗核抗体的阳性率分别为 20%、25%和 50%。我们还回顾性分析了 21 例 COVID-19 重症和危重症患者的临床和实验室数据。COVID-19 患者存在自身免疫现象，本研究结果为预防免疫功能障碍和最佳免疫抑制治疗提供了依据。
