Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China.
Mediators Inflamm. 2020 Sep 29;2020:6914878. doi: 10.1155/2020/6914878. eCollection 2020.
COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has threatened every civilian as a global pandemic. The immune system poses the critical interactive chain between the human body and the virus. Here, we make efforts to examine whether comorbidity with type 2 diabetes (T2D) affects the immunological response in COVID-19 patients.
We conducted a retrospective pilot study investigating immunological characteristics of confirmed cases of COVID-19 with or without comorbid T2D. Two subcohorts of sex- and age-matched participants were eligible for data analysis, of which 33 participants were with T2D and the remaining 37 were nondiabetic (NDM). Cellular immunity was assessed by flow cytometric determination of surface markers including CD3, CD4, CD8, CD19, CD16, and CD56 in peripheral blood. Levels of C reactive protein, immunoglobulin (IgG, IgM, IgA, and IgE), and complements (C3, C4) were detected by rate nephelometry immunoassay. And Th1/Th2 cytokines (IL-2, IL-4, IL-6, IL-10, TNF-, and IFN-) were detected by Cytometric Bead Array.
Neutrophil counts were found to be significantly higher in the T2D group than in the NDM group and had a significant relevance with clinical severity. Lymphocyte frequencies showed no significant differences in the two groups. However, the proportions and absolute counts of T, Tc, Th, and NK cells decreased in both groups to different degrees. An abnormal increase in neutrophil count and a decrease in lymphocyte subpopulations may represent risk factors of COVID-19 severity. The level of IgG, IgM, IgA, C3, and C4 showed no significant difference between the two groups, while the IgE levels were higher in the T2D group than in the NDM group ( < 0.05). Th1 cytokines including IFN-, TNF-, and IL-6, as well as CRP, appeared significantly higher in the T2D group.
The COVID-19 patients comorbid with T2D demonstrated distinguishable immunological parameters, which represented clinical relevancies with the predisposed disease severity in T2D.
由严重急性呼吸系统综合症冠状病毒 2（SARS-CoV-2）引起的 COVID-19 作为一种全球大流行疾病威胁着每一个平民。免疫系统是人体与病毒之间关键的互动链。在这里，我们努力研究 2 型糖尿病（T2D）合并症是否会影响 COVID-19 患者的免疫反应。
我们进行了一项回顾性试点研究，调查了合并或不合并 T2D 的 COVID-19 确诊病例的免疫学特征。两个亚组的性别和年龄匹配参与者符合数据分析条件，其中 33 名参与者患有 T2D，其余 37 名参与者为非糖尿病（NDM）。通过流式细胞术测定外周血中包括 CD3、CD4、CD8、CD19、CD16 和 CD56 在内的表面标志物来评估细胞免疫。通过速率散射比浊免疫测定法检测 C 反应蛋白、免疫球蛋白（IgG、IgM、IgA 和 IgE）和补体（C3、C4）的水平。通过 Cytometric Bead Array 检测 Th1/Th2 细胞因子（IL-2、IL-4、IL-6、IL-10、TNF- 和 IFN-）。
发现 T2D 组的中性粒细胞计数明显高于 NDM 组，并且与临床严重程度有显著相关性。两组间淋巴细胞频率无显著差异。然而，两组 T、Tc、Th 和 NK 细胞的比例和绝对计数均有不同程度的下降。中性粒细胞计数异常增加和淋巴细胞亚群减少可能是 COVID-19 严重程度的危险因素。两组间 IgG、IgM、IgA、C3 和 C4 水平无显著差异，而 T2D 组 IgE 水平高于 NDM 组（<0.05）。T2D 组 Th1 细胞因子包括 IFN-、TNF-和 IL-6 以及 CRP 明显升高。
合并 T2D 的 COVID-19 患者表现出可区分的免疫学参数，这些参数与 T2D 易患疾病的严重程度具有临床相关性。
