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免疫参数与 COVID-19 感染——与临床严重程度和疾病预后的关联。

Immune Parameters and COVID-19 Infection - Associations With Clinical Severity and Disease Prognosis.

机构信息

Department of Pediatrics, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia.

Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia.

出版信息

Front Cell Infect Microbiol. 2020 Jun 30;10:364. doi: 10.3389/fcimb.2020.00364. eCollection 2020.

Abstract

Severe acute respiratory syndrome caused by a novel 2019 coronavirus (SARS-CoV2) represents one of the most studied infectious diseases of today. The number of scientific reports and publications increases exponentially day by day. While the majority of infected subjects are asymptomatic or show mild symptoms, there is an important proportion of patients who requires hospitalization and, sometimes, intensive care. Immune response to novel coronavirus is complex, involves both innate and adaptive immunity, and is biphasic. Significant differences were observed when comparing severe and non-severe patients. Analysis of the reported results from clinical trials clearly show an involvement of specific cellular immunity (predominantly leucopenia, decreased counts of CD3, CD4, and CD8 T lymphocytes, changes of T cell compartment) and the so-called cytokine storm, which is associated with worsening of symptoms and the promotion of lung damage. An interesting finding regarding eosinopenia that can have both diagnostic and prognostic value is reported by some authors. Examination of selected immune parameters could help to identify severe patients with the risk of unfavorable course of the disease, predict the prognosis and recognize improvement in the clinical status. Moreover, detailed analysis of the immune changes could help to select novel prospective therapeutic strategies.

摘要

由新型 2019 冠状病毒(SARS-CoV2)引起的严重急性呼吸综合征是当今研究最多的传染病之一。科学报告和出版物的数量每天都呈指数级增长。虽然大多数感染的患者无症状或表现为轻度症状,但仍有相当一部分患者需要住院治疗,有时甚至需要重症监护。对新型冠状病毒的免疫反应是复杂的,涉及固有免疫和适应性免疫,并且是双相的。严重和非严重患者之间观察到显著差异。对临床试验报告结果的分析清楚地表明,存在特定的细胞免疫参与(主要是白细胞减少症、CD3、CD4 和 CD8 T 淋巴细胞计数减少、T 细胞区室的变化)和所谓的细胞因子风暴,这与症状恶化和促进肺损伤有关。一些作者报告了关于嗜酸性粒细胞减少症的有趣发现,它具有诊断和预后价值。检查选定的免疫参数可以帮助识别有疾病不良病程风险的严重患者,预测预后,并识别临床状况的改善。此外,对免疫变化的详细分析可以帮助选择新的有前途的治疗策略。

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