Internal Medicine Department, Bashkir State Medical University, Ufa, Russia.
Republic Medical Genetic Center, Ufa, Russia.
Front Immunol. 2022 May 6;13:856883. doi: 10.3389/fimmu.2022.856883. eCollection 2022.
The immune system is severely compromised in patients with COVID-19. The representative group of 43 patients were selected from the cohort of 342 patients with COVID-19 and pneumonia. This group of 43 patients was examined for the levels of C-reactive protein, biomarker of systemic inflammation, and for the subsets of adaptive immune cells. The immunological parameters were correlated with the metabolic parameters and cardiovascular pathology history. We identified that a decrease in the absolute number of T-lymphocytes, T-cytotoxic, T-activated and B-lymphocytes correlated with the higher levels of CRP. The absolute number of T-helpers and the absolute number of double positive T-lymphocytes positively correlated with the levels of iron in serum (Z= 0,310 and Z=0,394). The absolute numbers of T-activated lymphocytes positively correlated with serum levels of LDH (Z = 0,422), ferritin (Z = 0,407) and iron (Z = 0,418). When studying subpopulations of lymphocytes, depending on the combined pathology, we found that the absolute numbers of B-lymphocytes and double positive T-lymphocytes in the peripheral blood were significantly reduced in patients with arterial hypertension (p=0,0074 and p=0,0227, correspondingly). The increased levels of NK cell were found in patients with a history of coronary heart disease (p=0,0108). In addition, we found that deficiencies in the adaptive immune system correlated with the deficiencies in iron metabolism. The cardiovascular pathology upsets the balance in the adaptive and innate immune system in the circulation of patient with severe COVID-19.
免疫系统在 COVID-19 患者中受到严重损害。从 342 名 COVID-19 和肺炎患者队列中选择了 43 名有代表性的患者进行研究。这 43 名患者接受了 C-反应蛋白(全身炎症的生物标志物)和适应性免疫细胞亚群水平的检查。免疫参数与代谢参数和心血管病史相关。我们发现,T 淋巴细胞、T 细胞毒性、T 激活和 B 淋巴细胞的绝对数量减少与 CRP 水平升高相关。T 辅助细胞的绝对数量和双阳性 T 淋巴细胞的绝对数量与血清中铁的水平呈正相关(Z=0.310 和 Z=0.394)。T 激活淋巴细胞的绝对数量与血清 LDH(Z=0.422)、铁蛋白(Z=0.407)和铁(Z=0.418)水平呈正相关。在研究淋巴细胞亚群时,根据合并症,我们发现高血压患者外周血 B 淋巴细胞和双阳性 T 淋巴细胞的绝对数量明显减少(p=0.0074 和 p=0.0227)。冠心病患者的 NK 细胞水平升高(p=0.0108)。此外,我们发现适应性免疫系统的缺陷与铁代谢的缺陷相关。心血管病史会扰乱严重 COVID-19 患者循环中适应性和固有免疫系统的平衡。