SET-118, Department of Pre-hospital and Emergency, SG Giuseppe Moscati Hospital, Taranto, Italy.
Department of Multidisciplinary Research Centre, Lincoln University, Oakland CA, USA.
J Biol Regul Homeost Agents. 2021 Jan-Feb;35(1):171-183. doi: 10.23812/20-605-A.
The coronavirus disease 2019 (COVID-19) pandemic is a worldwide medical challenge due to the scarcity of proper information and remedial resources. The ability to efficiently avoid a further SARS-CoV-2 pandemic will, therefore, depend on understanding several factors which include host immunity, virus behavior, prevention measures, and new therapies. This is a multi-phase observatory study conducted in the SG Moscati Hospital of Taranto in Italy that was converted into COVID-19 Special Care Unit for SARS-Co-V2 risk management. Patients were admitted to the 118 Emergency Pre-Hospital and Emergency Department based on two diagnostic criteria, the nasopharyngeal swab assessed by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) and CT-scan image characterized by ground glass opacity. Patients were divided into four groups, positive-positive (ER-PP), negative-positive (ER-NP), negative-negative (ER-NN) and a group admitted to the ICU (ER-IC). A further control group was added when the T and B lymphocyte subsets were analyzed. Data included gender, age, vital signs, arterial blood gas analysis (ABG), extensive laboratory results with microbiology and bronchoalveolar lavage fluid (BALF) which were analyzed and compared. Fundamental differences were reported among the groups. Males were significantly higher in PP, ICU, and NP groups, from 2 to 4-fold higher than females, while in the NN group, the number of females was mildly higher than males; the PP patients showed a marked alkalotic, hypoxic, hypocapnia ABG profile with hyperventilation at the time of admission; finally, the laboratory and microbiology results showed lymphopenia, fibrinogen, ESR, CRP, and eGFR were markedly anomalous. The total number of CD4+ and CD8+ T cells was dramatically reduced in COVID-19 patients with levels lower than the normal range delimited by 400/μL and 800/μL, respectively, and were negatively correlated with blood inflammatory responses.
新型冠状病毒病 2019（COVID-19）大流行是一项全球性的医学挑战，这是由于缺乏适当的信息和治疗资源所致。因此，能否有效地避免再次发生 SARS-CoV-2 大流行，将取决于对几个因素的了解，这些因素包括宿主免疫、病毒行为、预防措施和新疗法。这是在意大利塔兰托的 Moscati 医院进行的一项多阶段观察性研究，该医院已转变为 COVID-19 特殊护理病房，以管理 SARS-Co-V2 风险。患者根据以下两个诊断标准被收入 118 紧急院前和急诊部，标准为鼻咽拭子通过逆转录-聚合酶链反应（RT-PCR）评估和 CT 扫描图像呈磨玻璃样混浊。患者分为四组，阳性-阳性（ER-PP）、阴性-阳性（ER-NP）、阴性-阴性（ER-NN）和一组收入 ICU（ER-IC）。当分析和比较 T 和 B 淋巴细胞亚群时，还增加了一个对照组。数据包括性别、年龄、生命体征、动脉血气分析（ABG）、广泛的实验室结果，包括微生物学和支气管肺泡灌洗液（BALF），并对其进行了分析和比较。各组之间报道了明显的差异。男性在 PP、ICU 和 NP 组中明显更高，是女性的 2 至 4 倍，而在 NN 组中，女性人数略高于男性；PP 患者在入院时的 ABG 表现为明显的碱中毒、低氧血症、低碳酸血症和过度通气；最后，实验室和微生物学结果显示淋巴细胞减少、纤维蛋白原、ESR、CRP 和 eGFR 明显异常。COVID-19 患者的总 CD4+和 CD8+T 细胞数量显著减少，水平低于分别为 400/μL 和 800/μL 限定的正常范围，并且与血液炎症反应呈负相关。
