Translational Reseach Unit. Hospital de Especialidades Centro Médico Nacional "La Raza" IMSS, Mexico City, Mexico.
Morphology Department. Escuela Nacional de Ciencias Biológicas. Instituto Politécnico Nacional (ENCB-IPN), Mexico City, Mexico.
Isr Med Assoc J. 2021 Mar;23(3):153-159.
Immune cell counts in blood in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection may be useful prognostic biomarkers of disease severity, mortality, and response to treatment.
To analyze sub-populations of lymphocytes at hospital admission in survivors and deceased from severe pneumonia due to coronavirus disease-2019 (COVID-19).
We conducted a cross-sectional study of healthcare workers confirmed with SARS-CoV-2 in convalescents (control group) and healthy controls (HC) diagnosed with severe COVID-19. Serum samples were taken at hospital admission and after recovery. Serum samples ≥ 25 days after onset of symptoms were analyzed for lymphocyte subpopulations through flow cytometry. Descriptive statistics, Kruskall-Wallis test, receiver operating characteristic curve, calculation of sensitivity, specificity, predictive values, and Kaplan-Meier analysis were performed.
We included 337 patients: 120 HC, 127 convalescents, and 90 severe COVID-19 disease patients (50 survivors, 40 deceased). For T cells, total lymphocytes ≥ 800/μL, CD3+ ≥ 400/μL, CD4+ ≥ 180/μL, CD8+ ≥ 150/μL, B cells CD19+ ≥ 80/μL, and NK ≥ 34/μL subsets were associated with survival in severe COVID-19 disease patients. All subtypes of lymphocytes had higher concentrations in survivors than deceased, but similar between HC and convalescents. Leukocytes ≥ 10.150/μL or neutrophils ≥ 10,000/μL were associated with increased mortality. The neutrophil-to-lymphocyte ratio (NLR) ≥ 8.5 increased the probability of death in severe COVID-19 (odds ratio 11.68).
Total lymphocytes; NLR; and levels of CD3+, CD4+, CD8+, and NK cells are useful as biomarkers of survival or mortality in severe COVID-19 disease and commonly reach normal levels in convalescents.
严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）感染患者血液中的免疫细胞计数可能是疾病严重程度、死亡率和治疗反应的有用预后生物标志物。
分析因 2019 年冠状病毒病（COVID-19）导致严重肺炎而存活和死亡的幸存者入院时淋巴细胞亚群。
我们对恢复期（对照组）和确诊 SARS-CoV-2 的医护人员进行了一项横断面研究。我们对因 COVID-19 而严重的患者进行了回顾性分析。在入院时和康复后采集血清样本。通过流式细胞术分析症状发作后≥25 天的血清样本中的淋巴细胞亚群。进行描述性统计、克鲁斯卡尔-沃利斯检验、受试者工作特征曲线、计算灵敏度、特异性、预测值和 Kaplan-Meier 分析。
共纳入 337 例患者：120 例健康对照者，127 例恢复期患者，90 例严重 COVID-19 患者（50 例存活，40 例死亡）。对于 T 细胞，总淋巴细胞计数≥800/μL、CD3+≥400/μL、CD4+≥180/μL、CD8+≥150/μL、B 细胞 CD19+≥80/μL、NK≥34/μL 与严重 COVID-19 患者的生存相关。所有淋巴细胞亚型在存活者中的浓度均高于死亡者，但在健康对照者和恢复期患者之间相似。白细胞计数≥10.150/μL 或中性粒细胞计数≥10，000/μL 与死亡率增加相关。中性粒细胞与淋巴细胞比值（NLR）≥8.5 增加了严重 COVID-19 死亡的概率（比值比 11.68）。
总淋巴细胞计数、NLR 以及 CD3+、CD4+、CD8+和 NK 细胞水平可作为严重 COVID-19 患者生存或死亡的生物标志物，且在恢复期通常恢复正常水平。
