T细胞亚群和白细胞介素-10水平是COVID-19严重程度和死亡率的预测指标：一项系统评价和荟萃分析
T-Cell Subsets and Interleukin-10 Levels Are Predictors of Severity and Mortality in COVID-19: A Systematic Review and Meta-Analysis.
作者信息
Alshammary Amal F, Alsughayyir Jawaher M, Alharbi Khalid K, Al-Sulaiman Abdulrahman M, Alshammary Haifa F, Alshammary Heba F
机构信息
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Department of Medical and Molecular Virology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
出版信息
Front Med (Lausanne). 2022 Apr 28;9:852749. doi: 10.3389/fmed.2022.852749. eCollection 2022.
BACKGROUND
Many COVID-19 patients reveal a marked decrease in their lymphocyte counts, a condition that translates clinically into immunodepression and is common among these patients. Outcomes for infected patients vary depending on their lymphocytopenia status, especially their T-cell counts. Patients are more likely to recover when lymphocytopenia is resolved. When lymphocytopenia persists, severe complications can develop and often lead to death. Similarly, IL-10 concentration is elevated in severe COVID-19 cases and may be associated with the depression observed in T-cell counts. Accordingly, this systematic review and meta-analysis aims to analyze T-cell subsets and IL-10 levels among COVID-19 patients. Understanding the underlying mechanisms of the immunodepression observed in COVID-19, and its consequences, may enable early identification of disease severity and reduction of overall morbidity and mortality.
METHODS
A systematic search was conducted covering PubMed MEDLINE, Scopus, Web of Science, and EBSCO databases for journal articles published from December 1, 2019 to March 14, 2021. In addition, we reviewed bibliographies of relevant reviews and the medRxiv preprint server for eligible studies. Our search covered published studies reporting laboratory parameters for T-cell subsets (CD4/CD8) and IL-10 among confirmed COVID-19 patients. Six authors carried out the process of data screening, extraction, and quality assessment independently. The DerSimonian-Laird random-effect model was performed for this meta-analysis, and the standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for each parameter.
RESULTS
A total of 52 studies from 11 countries across 3 continents were included in this study. Compared with mild and survivor COVID-19 cases, severe and non-survivor cases had lower counts of CD4/CD8 T-cells and higher levels of IL-10.
CONCLUSION
Our findings reveal that the level of CD4/CD8 T-cells and IL-10 are reliable predictors of severity and mortality in COVID-19 patients. The study protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number CRD42020218918.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218918, identifier: CRD42020218918.
背景
许多新冠肺炎患者的淋巴细胞计数显著下降，这种情况在临床上表现为免疫抑制，在这些患者中很常见。感染患者的预后因淋巴细胞减少状态而异，尤其是他们的T细胞计数。淋巴细胞减少症得到缓解时，患者更有可能康复。当淋巴细胞减少持续存在时，可能会出现严重并发症并常常导致死亡。同样，在重症新冠肺炎病例中，白细胞介素-10（IL-10）浓度升高，可能与观察到的T细胞计数降低有关。因此，本系统评价和荟萃分析旨在分析新冠肺炎患者的T细胞亚群和IL-10水平。了解新冠肺炎中观察到的免疫抑制的潜在机制及其后果，可能有助于早期识别疾病严重程度并降低总体发病率和死亡率。
方法
进行了一项系统检索，涵盖PubMed MEDLINE、Scopus、Web of Science和EBSCO数据库，以查找2019年12月1日至2021年3月14日发表的期刊文章。此外，我们查阅了相关综述的参考文献以及medRxiv预印本服务器以寻找符合条件的研究。我们的检索涵盖了报告确诊新冠肺炎患者T细胞亚群（CD4/CD8）和IL-10实验室参数的已发表研究。六位作者独立进行数据筛选、提取和质量评估过程。本荟萃分析采用DerSimonian-Laird随机效应模型，并计算每个参数的标准化平均差（SMD）和95%置信区间（CI）。
结果
本研究纳入了来自三大洲11个国家的52项研究。与轻症和康复的新冠肺炎病例相比，重症和未康复病例的CD4/CD8 T细胞计数较低，IL-10水平较高。
结论
我们的研究结果表明，CD4/CD8 T细胞水平和IL-10是新冠肺炎患者严重程度和死亡率的可靠预测指标。该研究方案已在国际系统评价前瞻性注册库（PROSPERO）注册；注册号CRD42020218918。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218918，标识符：CRD42020218918。
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