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中国武汉 COVID-19 患者一线医护人员的免疫反应。

Immune response of frontline medical workers providing medical support for Wuhan COVID-19 patients, China.

机构信息

Department of Health Management, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.

Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.

出版信息

Int Immunopharmacol. 2021 May;94:107479. doi: 10.1016/j.intimp.2021.107479. Epub 2021 Feb 16.

Abstract

The outbreak of novel coronavirus disease 2019 (COVID-19) posed a great challenge and stress to frontline medical workers in China. Stress is closely related to immunity. However, the immune response of frontline medical workers providing medical support for COVID-19 patients is unclear. Here, we reported the immune response of 76 frontline medical workers and 152 controls from the Second Affiliated Hospital of Xi'an Jiaotong University. The frontline medical workers were involved in the care for Wuhan COVID-19 patients from February 8 to March 31, 2020 in Tongji Hospital of Huazhong University of Science and Technology. The controls were medical workers of our hospital who had not been in contact with COVID-19 patients during the same period. Demographic and clinical data, including routine blood test data were extracted from the electronic health examination record and retrospectively analyzed. The post-stress frontline medical workers had higher lymphocyte (LYM) count compared with controls or pre-stress. However, the post-stress frontline medical workers had lower monocyte (MONO) count, neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and neutrophil (NEUT) ratio than controls or pre-stress. Interestingly, we found the differences were more significantly in female subgroup and nurse subgroup. Together, these data indicated that changes of immune response were found in frontline medical workers providing medical support for Wuhan COVID-19 patients, especially in females and nurses. Those maybe caused by psychological stress and we recommend to pay more attention to mental health of frontline medical workers, and provide appropriate psychological interventions for them.

摘要

2019 年新型冠状病毒病(COVID-19)的爆发给中国的一线医务人员带来了巨大的挑战和压力。压力与免疫密切相关。然而,为 COVID-19 患者提供医疗支持的一线医务人员的免疫反应尚不清楚。在这里,我们报道了西安交通大学第二附属医院的 76 名一线医务人员和 152 名对照者的免疫反应。这些一线医务人员参与了华中科技大学同济医院对武汉 COVID-19 患者的护理,时间为 2020 年 2 月 8 日至 3 月 31 日。对照组为我院同期未接触 COVID-19 患者的医务人员。从电子健康体检记录中提取人口统计学和临床数据,包括常规血常规数据,并进行回顾性分析。与对照组或应激前相比,应激后的一线医务人员淋巴细胞(LYM)计数较高。然而,应激后的一线医务人员单核细胞(MONO)计数、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)和中性粒细胞(NEUT)比值均低于对照组或应激前。有趣的是,我们发现这些差异在女性亚组和护士亚组更为显著。总之,这些数据表明,为武汉 COVID-19 患者提供医疗支持的一线医务人员的免疫反应发生了变化,尤其是女性和护士。这些变化可能是由心理压力引起的,我们建议更多地关注一线医务人员的心理健康,并为他们提供适当的心理干预。

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