Department of Biochemistry & Molecular Biology, University of Chittagong, Chattogram, Bangladesh; EuGEF Research Foundation, Chattogram, Bangladesh.
Department of Biochemistry & Molecular Biology, University of Chittagong, Chattogram, Bangladesh; EuGEF Research Foundation, Chattogram, Bangladesh; Stem Cell Genetics, Institute for Life and Medical Sciences, Kyoto University, Kyoto, Japan.
Exp Hematol. 2023 Feb;118:53-64.e1. doi: 10.1016/j.exphem.2022.11.006. Epub 2022 Nov 28.
The manifestation of coronavirus disease 2019 (COVID-19) severity and mortality has been associated with dysregulation of the immune response, often influenced by racial disparities and conferred by changes in hematologic and immunologic parameters. These biological and hematologic parameters as well as cytokine profiles were investigated in a cohort of 61 COVID-19-positive patients (categorized into mild, moderate, and severe groups) from Bangladesh using standard analytical methods. The data reported that the interleukin (IL)-4 and IL-6 levels were significantly increased, whereas the levels of interferon (IFN)-γ were significantly reduced in patients with severe COVID-19 (p < 0.05) compared with those in patients with mild and/or moderate COVID-19. The extent of erythrocyte sedimentation rate (ESR); neutrophil count; and levels of ferritin, C-reactive protein (CRP), and D-dimer (p < 0.05) were found to be significantly increased, whereas the white blood cell (WBC), lymphocyte, eosinophil, and platelet counts (p < 0.05) were observed to be significantly reduced in patients with severe COVID-19 compared with those in the patients in other 2 groups. Our study exhibited a significantly higher IL-6-to-lymphocyte ratio in patients with severe COVID-19 than in those with mild and moderate COVID-19. The calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and ferritin-to-ESR ratio were significantly increased in patients with severe COVID-19. The increase in the IL-4 and IL-6 levels along with CRP and D-dimer levels may envisage a hyperinflammatory environment and immune dysregulation, which contribute to prolonged viral persistence, leading to severe disease. However, the reduced level of IFN-γ can be attributed to a less fatality toll in Bangladesh compared with that in the rest of the world.
新型冠状病毒病 2019（COVID-19）的严重程度和死亡率与免疫反应失调有关，这种失调通常受到种族差异的影响，并由血液和免疫参数的变化所决定。本研究使用标准分析方法，对来自孟加拉国的 61 例 COVID-19 阳性患者（分为轻症、中症和重症三组）的这些生物学和血液参数以及细胞因子谱进行了研究。数据报告显示，与轻症和/或中症 COVID-19 患者相比，重症 COVID-19 患者的白细胞介素（IL）-4 和 IL-6 水平显著升高，而干扰素（IFN）-γ水平显著降低（p < 0.05）。红细胞沉降率（ESR）、中性粒细胞计数、铁蛋白、C 反应蛋白（CRP）和 D-二聚体水平显著升高（p < 0.05），而白细胞、淋巴细胞、嗜酸性粒细胞和血小板计数显著降低（p < 0.05）。与轻症和中症 COVID-19 患者相比，重症 COVID-19 患者的 IL-6 与淋巴细胞比值显著升高。计算得出的中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）和铁蛋白与 ESR 比值在重症 COVID-19 患者中显著升高。IL-4 和 IL-6 水平以及 CRP 和 D-二聚体水平的升高可能预示着一种过度炎症环境和免疫失调，这有助于病毒持续存在，导致疾病加重。然而，与世界其他地区相比，孟加拉国 IFN-γ 水平降低可能导致死亡率降低。
