Scalia Giulia, Raia Maddalena, Gelzo Monica, Cacciapuoti Sara, Rosa Annunziata De, Pinchera Biagio, Scotto Riccardo, Tripodi Lorella, Mormile Mauro, Fabbrocini Gabriella, Gentile Ivan, Parrella Roberto, Castaldo Giuseppe, Scialò Filippo
CEINGE-Biotecnologie Avanzate, Scarl, 80131 Naples, Italy.
Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy.
J Clin Med. 2022 Jul 25;11(15):4306. doi: 10.3390/jcm11154306.
We previously observed an increase of serum interleukins (IL) and a reduction of most lymphocyte subpopulations in hospitalized COVID-19 patients. Herein, we aimed to evaluate the changes in serum IL-6, IL-10, and IL-17A levels and cytometric lymphocyte profiles in 144 COVID-19 patients at admission and after one week, also in relation to steroid treatment before hospitalization. After one week of hospitalization, we found that: (i) total lymphocytes were increased in all patients; (ii) neutrophils and IL-6 were reduced in mild/moderate patients; (iii) B lymphocytes were increased in severe patients; (iv) T lymphocyte populations increased in mild/moderate patients. In the eight patients that died during hospitalization, total leukocytes increased while T, T helper, T cytotoxic, T regulatory, and NK lymphocytes showed a reducing trend in five of the eight patients. Even if seven days are too few to evaluate the adaptive immunity of patients, we found that the steroid therapy was associated with a reduced COVID-19 inflammation and cytokine activation only in patients with severe disease, while in patients with less severe disease, the steroid therapy seems to have immunosuppressive effects on lymphocyte populations, and this could hamper the antiviral response. A better knowledge of cytokine and lymphocyte alterations in each COVID-19 patient could be useful to plan better treatment with steroids or cytokine targeting.
我们之前观察到，住院的新冠病毒肺炎（COVID-19）患者血清白细胞介素（IL）增加，大多数淋巴细胞亚群减少。在此，我们旨在评估144例COVID-19患者入院时及一周后的血清IL-6、IL-10和IL-17A水平变化以及流式细胞术检测的淋巴细胞谱，同时研究其与住院前类固醇治疗的关系。住院一周后，我们发现：（i）所有患者的总淋巴细胞均增加；（ii）轻症/中症患者的中性粒细胞和IL-6减少；（iii）重症患者的B淋巴细胞增加；（iv）轻症/中症患者的T淋巴细胞群体增加。在住院期间死亡的8例患者中，总白细胞增加，而8例患者中有5例的T细胞、辅助性T细胞、细胞毒性T细胞、调节性T细胞和自然杀伤（NK）淋巴细胞呈减少趋势。即使7天时间对于评估患者的适应性免疫来说太短，但我们发现类固醇治疗仅在重症患者中与COVID-19炎症和细胞因子激活的减轻相关，而在病情较轻的患者中，类固醇治疗似乎对淋巴细胞群体具有免疫抑制作用，这可能会妨碍抗病毒反应。更好地了解每位COVID-19患者的细胞因子和淋巴细胞变化，可能有助于规划更优的类固醇或细胞因子靶向治疗方案。
