Xu Jingjing, Liu Zhiyu, Liu Haitao, Luo Yunpeng, Kang Kai, Li Xueting, Yang Wei, Fei Dongsheng, Wang Changsong, Yu Kaijiang
Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, People's Republic of China.
Department of Laboratory Diagnostics, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China.
J Inflamm Res. 2021 Apr 9;14:1331-1340. doi: 10.2147/JIR.S303117. eCollection 2021.
Since Dec. 2019, the COVID-19 pandemic has been an outbreak. T cells play an important role in dealing with various disease-causing pathogens. However, the role of T cells played in COVID-19 patients is still unknown. Our study aimed to describe the immunologic state of the critically ill COVID-19 patients.
A total of 63 patients with confirmed COVID-19 pneumonia were admitted to the Department of Intensive Care Unit of the First Affiliated Hospital of Harbin Medical University. The immunologic characteristics (lymphocyte apoptosis, the expression of PD-1 and HLA-DR in T cells, T cell subset levels, redistribution and the production of inflammatory factors) as well as their laboratory parameters were compared between severe group and critical group.
The level of T cells in peripheral blood was decreased in critical patients compared with that in severe patients, but the expression levels of PD-1 (CD4: 24.71% VS 30.56%; CD8: 33.05% VS 32.38%) and HLA-DR (T cells: 36.28% VS 27.44%; monocytes: 20.58% VS 23.83%) in T cells were not significantly changed, and apoptosis and necrosis were not different in lymphocytes (apoptosis: 1.04% VS 1.27%; necrosis: 0.67% VS 1.11%), granulocytes, or monocytes between those two groups.
There is severe immunosuppression in critically ill COVID-19 patients. Redistribution of T cells might be the main reason for lymphocytic decline. Decreasing the infiltration of T lymphocytes in the lung may be beneficial for the treatment of COVID-19.
自2019年12月以来，新型冠状病毒肺炎疫情爆发。T细胞在应对各种致病病原体方面发挥着重要作用。然而，T细胞在新型冠状病毒肺炎患者中所起的作用仍不清楚。我们的研究旨在描述危重型新型冠状病毒肺炎患者的免疫状态。
哈尔滨医科大学附属第一医院重症监护病房共收治63例确诊新型冠状病毒肺炎患者。比较重症组和危重组患者的免疫特征（淋巴细胞凋亡、T细胞中PD-1和HLA-DR的表达、T细胞亚群水平、重新分布及炎症因子产生）及其实验室参数。
与重症患者相比，危重症患者外周血T细胞水平降低，但T细胞中PD-1（CD4：24.71%对30.56%；CD8：33.05%对32.38%）和HLA-DR（T细胞：36.28%对27.44%；单核细胞：20.58%对23.83%）的表达水平无明显变化，两组淋巴细胞（凋亡：1.04%对1.27%；坏死：0.67%对1.11%）、粒细胞或单核细胞的凋亡和坏死情况也无差异。
危重型新型冠状病毒肺炎患者存在严重免疫抑制。T细胞重新分布可能是淋巴细胞减少的主要原因。减少T淋巴细胞在肺部的浸润可能有利于新型冠状病毒肺炎的治疗。
