Kang Yanli, Lu Shifa, Zhong Ruifang, You Jianbin, Chen Jiahao, Li Ling, Huang Rongbin, Xie Yanyan, Chen Falin, Chen Jinhua, Chen Liangyuan
Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
Department of Clinical Laboratory, JianOu Municipal Hospital of Fujian Province, Nanping, China.
Heliyon. 2023 Dec 12;10(1):e23583. doi: 10.1016/j.heliyon.2023.e23583. eCollection 2024 Jan 15.
Coronavirus disease 2019 (COVID-19) is associated with immune dysregulation and cytokine storm. It is essential to explore the immune response characteristics of peripheral circulation in COVID-19 patients to reveal pathogenesis and predict disease progression. In this study, the levels of total immunoglobulins (IgG, IgM, IgA), complement (C3, C4)，lymphocyte subsets (CD3 cell，CD4+ cell，CD8+ cell, NK cell, CD19 cell and CD45 cell) and cytokines (IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IL-12p, IL-1β, TNF-α, IFN-α and IFN-γ) were retrospectively analyzed in COVID-19 patients. A total of 513 patients were enrolled in this study, cases were distributed according to clinical status as mild or moderate (n = 212), severe survivors (n = 197) and severe non-survivors (n = 104). IL-6, IL-8, IL-10 and IFN-γ were increased in severe patients compared with non-severe patients, despite decreased CD45 cell, CD3 cell, CD4 cell, CD8 cell, CD19 cell, and NK cell. Compared with severe survivors, the levels of L-6, IL-8 and IL-10 in non-survivors increased significantly, and levels of C3, CD45 cell, CD3 cell，CD4+ cell，CD8+ cell, and NK cell decreased. Moreover, age, IL-8, IL-10, CD8+cells and NK cell were independent risk factors for the severity of COVID-19. Multivariable regression showed increasing odds ratio of in-hospital death associated with tumor, older age, higher IL-8 level, and decreasing odds ratio of in-hospital death associated with increased levels of CD8+cell and NK cell. Finally, patients with tumor, or high IL-6 or high IL-10 expression and lower CD8 or lower NK levels exhibited a significantly shorter survival time. In conclusion, our study provides findings of the immunological characteristics associated with disease severity to predict the progression of COVID-19. The immune inflammation factors, such as IL-6, IL-8, IL-10, CD8 cell and NK cell, could serve as excellent biomarkers for monitoring or predicting COVID-19 progression therapeutic to COVID-19 patients.
2019冠状病毒病（COVID-19）与免疫失调和细胞因子风暴有关。探索COVID-19患者外周循环的免疫反应特征对于揭示发病机制和预测疾病进展至关重要。在本研究中，对COVID-19患者的总免疫球蛋白（IgG、IgM、IgA）、补体（C3、C4）、淋巴细胞亚群（CD3细胞、CD4+细胞、CD8+细胞、NK细胞、CD19细胞和CD45细胞）以及细胞因子（IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-17、IL-12p、IL-1β、TNF-α、IFN-α和IFN-γ）水平进行了回顾性分析。本研究共纳入513例患者，病例根据临床状态分为轻症或中症（n = 212）、重症幸存者（n = 197）和重症非幸存者（n = 104）。与非重症患者相比，重症患者的IL-6、IL-8、IL-10和IFN-γ升高，尽管CD45细胞、CD3细胞、CD4细胞、CD8细胞、CD19细胞和NK细胞减少。与重症幸存者相比，非幸存者的IL-6、IL-8和IL-10水平显著升高，C3、CD45细胞、CD3细胞、CD4+细胞、CD8+细胞和NK细胞水平降低。此外，年龄、IL-8、IL-10、CD8+细胞和NK细胞是COVID-19严重程度的独立危险因素。多变量回归显示，与肿瘤、老年、较高的IL-8水平相关的院内死亡比值比增加，与CD8+细胞和NK细胞水平升高相关的院内死亡比值比降低。最后，患有肿瘤、或IL-6或IL-10高表达且CD8或NK水平较低的患者生存时间显著缩短。总之，我们的研究提供了与疾病严重程度相关的免疫学特征，以预测COVID-19的进展。免疫炎症因子，如IL-6、IL-8、IL-10、CD8细胞和NK细胞，可作为监测或预测COVID-19进展的优秀生物标志物，对COVID-19患者进行治疗。
