Bao F, Shi W L, Hu J, Zhang D, Gao D H, Xia Y X, Jing H M, Ke X Y, Ge Q G, Shen N
Department of Hematology, Peking University Third Hospital, Beijing 100191, China.
Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Dec 18;52(6):1075-1081. doi: 10.19723/j.issn.1671-167X.2020.06.014.
To understand the differences in lymphocyte subsets in patients with different clinical classifications of corona virus disease 19 (COVID-19).
Eighty-one patients with COVID-19 who were admitted to the isolation ward under the responsibility of three medical aid teams in the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, from February 8, 2020 to March 28, 2020, were selected to collect clinical data. According to the relevant diagnostic criteria, the disease status of the patients was classified into moderate cases (=35), severe cases (=39) and critical cases (=7) when lymphocyte subset testing was performed. Their blood routine tests, lymphocyte subsets and other indicators were tested to compare whether there were differences in each indicator between the patients of different clinical classification groups.
The differences in the absolute count of total lymphocytes, T-lymphocytes, CD4T-lymphocytes, CD8T-lymphocytes and natural killer (NK) cells among the three groups of patients were all statistically significant ( < 0.05), and the critical cases were significantly lower than the moderate and severe cases in the above indicators, and the indicators showed a decreasing trend with the severity of the disease. In 22 patients, the six indicators of the absolute count of T-lymphocytes, B-lymphocytes, CD4T-lymphocytes, CD8T-lymphocytes and NK cells, CD4/CD8 ratio were all within the normal reference range in the first test, and 59 patients had abnormalities of the above indicators, with the absolute count of NK cells and CD8 T lymphocytes decreasing most frequently (61%, 56%). The patients with the absolute count of NK cells and CD8 T lymphocytes below the normal reference range were one group, and the remaining abnormal patients were the other group. There were more critical cases in the former group (moderate : severe : critical cases were 4 : 8 : 7 . 19 : 21 : 0, respectively, =0.001), and all the deaths were in this group (6 cases . 0 case, =0.001). The absolute B lymphocyte count was below the normal reference range in 15 patients, and the remaining 64 cases were within the normal range. The ratio of moderate, severe and critical cases in the reduced group was 4 : 7 : 4, and the ratio of critical cases was more in normal group which was 30 : 31 : 3, and the difference between the two groups was statistically significant (=0.043).
The more critical the clinical subtype of patients with COVID-19, the lower the absolute count of each subset of lymphocytes.
了解新型冠状病毒肺炎（COVID-19）不同临床分型患者淋巴细胞亚群的差异。
选取2020年2月8日至2020年3月28日在华中科技大学同济医学院附属同济医院三个医疗援助团队负责的隔离病房收治的81例COVID-19患者，收集临床资料。根据相关诊断标准，在进行淋巴细胞亚群检测时，将患者的病情状态分为中型（=35例）、重型（=39例）和危重型（=7例）。检测其血常规、淋巴细胞亚群等指标，比较不同临床分型组患者各指标是否存在差异。
三组患者的淋巴细胞总数、T淋巴细胞、CD4T淋巴细胞、CD8T淋巴细胞和自然杀伤（NK）细胞绝对计数差异均有统计学意义（<0.05），危重型患者上述指标显著低于中型和重型患者，且指标随疾病严重程度呈下降趋势。22例患者首次检测时T淋巴细胞、B淋巴细胞、CD4T淋巴细胞、CD8T淋巴细胞和NK细胞绝对计数、CD4/CD8比值六项指标均在正常参考范围内，59例患者上述指标异常，其中NK细胞和CD8 T淋巴细胞绝对计数下降最为频繁（分别为61%、56%）。将NK细胞和CD8 T淋巴细胞绝对计数低于正常参考范围的患者分为一组，其余异常患者分为另一组。前一组危重型病例较多（中型：重型：危重型病例分别为4:8:7与19:21:0，=0.001），且所有死亡病例均在该组（6例与0例，=0.001）。15例患者B淋巴细胞绝对计数低于正常参考范围，其余64例在正常范围内。减少组中型、重型和危重型病例比例为4:7:4，正常组危重型病例比例较多，为30:31:3，两组差异有统计学意义（=0.043）。
COVID-19患者临床亚型越危重，淋巴细胞各亚群的绝对计数越低。
