Science and Research branch, AJA University of Medical Sciences, Tehran, Iran.
Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
PLoS One. 2022 Aug 5;17(8):e0268712. doi: 10.1371/journal.pone.0268712. eCollection 2022.
Available but insufficient evidence shows that changes may occur in the immune system following coronavirus disease 2019 (COVID-19). The present study aimed at evaluating immunological changes in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia compared with the control group.
The present study was performed on 95 patients with COVID-19 (32 severe and 63 moderate cases) and 22 healthy controls. Relationship between immune cells, disease severity and lung involvement was assessed. Binary logistic regression and ROC curve tests were used for statistical analysis.
A significant decrease was observed in CD20+ cell counts of the patients. To differentiate patients from healthy individuals, the cutoff point for the CD4+ cell count was 688 /μL, sensitivity 0.96, and specificity 0.84. An increase in CD4+ cells reduces the odds of severe disease (odds ratio = 0.82, P = 0.047) and death (odds ratio = 0.74, P = 0.029). CD4+ cells play a pivotal role in the severity of lung involvement (P = 0.03). In addition to CD4+ cells, Fc gamma receptor III (FcγRIII) (CD16) also played a significant prognosis (odds ratio = 0.55, P = 0.047). In severe cases, C-reactive protein, Blood urea nitrogen, and Creatine phosphokinase levels, as well as neutrophil counts, were significantly higher than those of moderate ones whereas lymphocyte count in severe cases was lower than that of moderate ones.
The number of total T-cells and B-cells in patients with COVID-19 was lower than that of controls; however, their NK cells increased. FcγRIII and CD4+ cells are of great importance due to their association with COVID-19 prognosis.
有证据表明，新冠肺炎（COVID-19）后，免疫系统可能会发生变化。本研究旨在评估严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）肺炎患者与对照组之间的免疫变化。
本研究纳入 95 例 COVID-19 患者（32 例重症，63 例轻症）和 22 例健康对照者。评估免疫细胞与疾病严重程度和肺部受累的关系。采用二项逻辑回归和 ROC 曲线检验进行统计学分析。
患者的 CD20+细胞计数显著下降。为了将患者与健康个体区分开来，CD4+细胞计数的截断值为 688/μL，敏感性为 0.96，特异性为 0.84。CD4+细胞的增加降低了发生重症疾病的几率（比值比=0.82，P=0.047）和死亡的几率（比值比=0.74，P=0.029）。CD4+细胞在肺部受累的严重程度中起着关键作用（P=0.03）。除 CD4+细胞外，FcγRIII（CD16）也具有显著的预后意义（比值比=0.55，P=0.047）。在重症病例中，C 反应蛋白、血尿素氮、肌酸磷酸激酶水平以及中性粒细胞计数均显著高于轻症病例，而重症病例的淋巴细胞计数则低于轻症病例。
COVID-19 患者的总 T 细胞和 B 细胞数量低于对照组，但其 NK 细胞增加。FcγRIII 和 CD4+细胞因其与 COVID-19 预后相关而非常重要。
