Biology Department, Foch Hospital, Suresnes, France.
UMRS-1176, Le Kremlin-Bicêtre, France.
Clin Chem Lab Med. 2021 Feb 22;59(7):1315-1322. doi: 10.1515/cclm-2020-1801. Print 2021 Jun 25.
Severe forms of coronavirus disease 2019 (COVID-19) are characterized by an excessive production of inflammatory cytokines. Activated monocytes secrete high levels of cytokines. Human monocytes are divided into three major populations: conventional (CD14CD16), non-classical (CD14CD16), and intermediate (CD14CD16) monocytes. The aim of this study was to analyze whether the distribution of conventional (CD16) and CD16 monocytes is different in patients with COVID-19 and whether the variations could be predictive of the outcome of the disease.
We performed a prospective study on 390 consecutive patients referred to the Emergency Unit, with a proven diagnosis of SARS-CoV 2 infection by RT-PCR. Using the CytoDiff™ reagent, an automated routine leukocyte differential, we quantified CD16 and CD16 monocytes.
In the entire population, median CD16 and CD16 monocyte levels (0.398 and 0.054×10/L, respectively) were in the normal range [(0.3-0.7×10/L) and (0.015-0.065×10/L), respectively], but the 35 patients in the intensive care unit (ICU) had a significantly (p<0.001) lower CD16 monocyte count (0.018 × 10/L) in comparison to the 70 patients who were discharged (0.064 × 10/L) or were hospitalized in conventional units (0.058 × 10/L). By ROC curve analysis, the ratio [absolute neutrophil count/CD16 monocyte count] was highly discriminant to identify patients requiring ICU hospitalization: with a cut-off 193.1, the sensitivity and the specificity were 74.3 and 81.8%, respectively (area under the curve=0.817).
Quantification of CD16 monocytes and the ratio [absolute neutrophil count/CD16 monocyte count] could constitute a marker of the severity of disease in COVID-19 patients.
严重的 2019 年冠状病毒病（COVID-19）的特征是炎症细胞因子的过度产生。活化的单核细胞分泌高水平的细胞因子。人类单核细胞分为三个主要群体：常规（CD14CD16）、非经典（CD14CD16）和中间（CD14CD16）单核细胞。本研究的目的是分析 COVID-19 患者中常规（CD16）和 CD16 单核细胞的分布是否不同，以及这些变化是否可以预测疾病的结局。
我们对 390 例连续就诊于急诊的患者进行了前瞻性研究，这些患者的 SARS-CoV 2 感染通过 RT-PCR 得到证实。使用 CytoDiff™试剂，一种自动化的常规白细胞分类试剂，我们定量了 CD16 和 CD16 单核细胞。
在整个人群中，中位数 CD16 和 CD16 单核细胞水平（分别为 0.398 和 0.054×10/L）均在正常范围内[（0.3-0.7×10/L）和（0.015-0.065×10/L）]，但 35 例在重症监护病房（ICU）的患者的 CD16 单核细胞计数显著（p<0.001）降低（0.018×10/L），与 70 例出院（0.064×10/L）或在普通病房住院（0.058×10/L）的患者相比。通过 ROC 曲线分析，比率[绝对中性粒细胞计数/CD16 单核细胞计数]对识别需要 ICU 住院的患者具有高度的判别能力：以 193.1 为截断值，灵敏度和特异性分别为 74.3%和 81.8%（曲线下面积=0.817）。
CD16 单核细胞的定量和比率[绝对中性粒细胞计数/CD16 单核细胞计数]可作为 COVID-19 患者疾病严重程度的标志物。
