Department of Otolaryngology - Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Yaxin School of Nursing, Wuhan Institute of Design and Sciences, Wuhan 430205, China.
Int J Infect Dis. 2020 Sep;98:353-358. doi: 10.1016/j.ijid.2020.07.003. Epub 2020 Jul 4.
Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread widely. The aim of this study was to investigate the dynamic changes in peripheral blood lymphocyte subsets in adult patients with COVID-19.
The electronic medical records were reviewed. Data including demographic characteristics, clinical manifestations, comorbidities, laboratory data, and radiological examinations of 435 hospitalized COVID-19 patients with a confirmed SARS-CoV-2 viral infection were extracted and analyzed retrospectively. Lymphocyte subset counts at each week after the onset of the illness were compared with those of the other weeks of illness and with those of control individuals.
The various lymphocyte subsets (CD3+, CD4+, CD8+, CD19+, and CD16/56+) were below the normal ranges at 1 week after the onset of illness, reaching a nadir during the second week. They increased gradually during the third week and returned to normal levels in the fifth week, but were still lower than those of the healthy controls. The CD3+, CD4+, and CD8+ counts were significantly lower in patients with severe disease compared to those with non-severe disease, and in patients who died compared to those who recovered.
This research indicates that the levels of peripheral blood lymphocyte subsets (CD3+, CD4+, and CD8+) are associated with disease progression and severity, and with the prognosis in patients with COVID-19. Dynamic monitoring of human immune function is one of the indicators for evaluating the severity of disease and the prognosis of COVID-19 patients, and is useful for formulating appropriate treatment strategies.
由严重急性呼吸综合征冠状病毒 2 （SARS-CoV-2）感染引起的 2019 年冠状病毒病（COVID-19）已广泛传播。本研究旨在探讨成人 COVID-19 患者外周血淋巴细胞亚群的动态变化。
回顾性分析了 435 例经证实的 SARS-CoV-2 病毒感染住院 COVID-19 患者的电子病历资料，提取并分析了患者的人口统计学特征、临床表现、合并症、实验室数据和影像学检查等数据。比较了发病后各周的淋巴细胞亚群计数与其他周的计数以及与健康对照者的计数。
发病后 1 周时，各种淋巴细胞亚群（CD3+、CD4+、CD8+、CD19+和 CD16/56+）均低于正常范围，第 2 周达到最低点。第 3 周逐渐升高，第 5 周恢复正常，但仍低于健康对照组。与非重症患者相比，重症患者的 CD3+、CD4+和 CD8+计数明显较低，死亡患者的 CD3+、CD4+和 CD8+计数明显低于康复患者。
本研究表明，外周血淋巴细胞亚群（CD3+、CD4+和 CD8+）水平与疾病进展和严重程度以及 COVID-19 患者的预后相关。动态监测人体免疫功能是评估 COVID-19 患者疾病严重程度和预后的指标之一，有助于制定适当的治疗策略。
