Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
Int Immunopharmacol. 2022 Sep;110:109019. doi: 10.1016/j.intimp.2022.109019. Epub 2022 Jul 6.
COVID-19 is an immune-related disease caused by novel Coronavirus SARS-COV-2. Lung lesions persist in some recovered patients, making long-term follow-up monitoring of their health necessary. The mechanism of these abnormalities is still unclear. In this study, the immune status was observed to explore the immune mechanism of persistent lung CT abnormalities in one-year COVID-19 recovered subjects.
One-year follow-up of 73 recovered patients from COVID-19 confirmed in Taizhou City, Zhejiang Province, was conducted to collect laboratory indicators such as blood immune cells, cytokines, complement series, immunoglobulin, and lung imaging; According to the results of lung CT, 60 patients were divided into normal CT group (n = 40) and abnormal CT group (n = 20). We compared the dynamic changes of immune indexes at three timepoints namely onset (T1), discharge (T2), and 1-year follow-up (T3), and studied the relationship between immune indexes and pulmonary sequelae.
Compared with the healthy control, there was no significant difference in immune-related indexes, and immune levels had recovered. Patients with elder age, high BMI, severe patients, and those with underlying diseases (hypertension or diabetes) had a higher CT abnormal rate after recovery. Longitudinal observation showed that immunoglobulin increased first and then decreased, immune cell TBNK decreased in the onset period and increased in the recovery period, cytokine level increased significantly in the onset period and decreased to the normal level in the recovery period, and complement series C1q, C3 and C4 increased at the onset and decreased during the one-year follow-up. Complement C3 remained at a high level in the CT abnormal group (CT normal group vs CT abnormal group; P = 0.036). Correlation analysis showed that C3 negatively correlated restrictive ventilation index (TLC-He (ratio) (r = -0.302, P = 0.017). The above results suggest that complement C3 is a negative factor correlating abnormal pulmonary function 1 year after the recovery.
After one year recovering from COVID-19, the subjects were with stable immune indicators. High levels of complement C3 were associated with persistent lung abnormalities in COVID-19 recovered subjects.
COVID-19 是一种由新型冠状病毒 SARS-COV-2 引起的与免疫相关的疾病。一些康复患者的肺部病变持续存在，因此需要对其健康状况进行长期随访监测。这些异常的发生机制尚不清楚。在这项研究中，我们观察了免疫状态，以探讨 COVID-19 康复患者 1 年后肺部 CT 异常的免疫机制。
对浙江省台州市确诊的 73 例 COVID-19 康复患者进行 1 年随访，收集血免疫细胞、细胞因子、补体系列、免疫球蛋白和肺部影像学等实验室指标；根据肺部 CT 结果，将 60 例患者分为正常 CT 组（n=40）和异常 CT 组（n=20）。比较了发病时（T1）、出院时（T2）和 1 年随访时（T3）三个时间点的免疫指标动态变化，并研究了免疫指标与肺部后遗症的关系。
与健康对照组相比，免疫相关指标无显著差异，免疫水平已恢复。年龄较大、BMI 较高、病情较重以及有基础疾病（高血压或糖尿病）的患者在康复后 CT 异常率较高。纵向观察显示，免疫球蛋白先升高后降低，免疫细胞 TBNK 在发病期减少，恢复期增加，细胞因子水平在发病期显著升高，恢复期恢复正常，补体 C1q、C3 和 C4 在发病期和 1 年随访期均升高。在 CT 异常组中，补体 C3 持续处于高水平（CT 正常组与 CT 异常组；P=0.036）。相关性分析显示，C3 与限制性通气指数（TLC-He（比值）呈负相关（r=-0.302，P=0.017）。上述结果提示，补体 C3 是 COVID-19 康复患者 1 年后肺部功能异常的负相关因素。
COVID-19 康复 1 年后，患者的免疫指标稳定。高水平的补体 C3 与 COVID-19 康复患者持续的肺部异常有关。
