Chen Zixi, Li Jinpeng, Zheng Jin, Xiang Fenfen, Li Xiaoxiao, Zhang Mengzhe, Kang Xiangdong, Wu Rong
Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, PR China.
Heliyon. 2024 Mar 20;10(6):e28451. doi: 10.1016/j.heliyon.2024.e28451. eCollection 2024 Mar 30.
This research aims to examine the involvement of lymphocyte subsets and inflammatory cytokines in the development and progression of COVID-19.
164 COVID-19 patients were admitted to hospital between December 2022 and January 2023. Based on lung CT scans and whether it is necessary for intensive care unit (ICU) admission, they were categorized into: severe groups (84) and mild disease groups (80). Peripheral blood were also collected from 101 healthy examinees and 164 patients. Flow cytometry (FCM) was used to measure the absolute and relative counts of lymphocyte subsets, while chemiluminescence was used to detect the level of inflammatory cytokines.
The COVID-19 patient group exhibited lower count of lymphocytes subsets than healthy control group. Moreover, COVID-19 patient case presented higher content of cytokines (IL-6, IL-4, IL-8, IL-10, and TNF-α) expression compared to healthy control case. Within the COVID-19 patient group, individuals with severe disease showed lower counts of lymphocytes subsets than the mild disease case. Furthermore, IL-6 levels in severe case were higher than the mild disease patients case. Multi-variate logistic regression analysis confirmed IL-6 (odds ratio: 0.985 [0.977-0.993]), CD3 T cells (odds ratio:1.007 [1.004-1.010]), CD8 T cells (odds ratio:1.016 [1.009-1.023]), and CD19 B cells (odds ratio:1.011 [1.002-1.020]) independently predicted severe progression. ROC curve results indicated AUC for lymphocytes in patients with severe COVID-19 was 0.8686 (0.8112-0.9260), CD3 T cells was 0.8762 (0.8237-0.9287), CD8 T cells was 0.7963 (0.7287-0.8638), CD4 T cells was 0.8600 (0.8036-0.9164), CD19 B cells was 0.7217 (0.6434-0.8001), NK cells was 0.6492 (0.5627-0.7357), age was 0.6699 (0.5877-0.7521), diabetes was 0.5991 (0.5125-0.6857), and IL-6 was 0.7241 (0.6479-0.8003). Furthermore, the ROC curves for different factors (CD3 T cells, age, IL-6) yielded an AUC of 0.9031 (0.8580-0.9483).
The research indicated that COVID-19 patients experience a decrease in lymphocytes subset and an increase in the inflammatory factor IL-6, particularly in the severe case group. As a result, the count of lymphocyte subset (CD3 T cells) and the content of inflammatory cytokine (IL-6) can serve as predictive markers for assessing the severity of COVID-19 and developing treatment plans efficacy.
本研究旨在探讨淋巴细胞亚群和炎性细胞因子在新型冠状病毒肺炎（COVID-19）发生发展过程中的作用。
选取2022年12月至2023年1月期间收治的164例COVID-19患者。根据肺部CT扫描结果及是否需要入住重症监护病房（ICU），将患者分为重症组（84例）和轻症组（80例）。同时采集101例健康体检者和164例患者的外周血。采用流式细胞术（FCM）检测淋巴细胞亚群的绝对计数和相对计数，采用化学发光法检测炎性细胞因子水平。
COVID-19患者组淋巴细胞亚群计数低于健康对照组。此外，与健康对照相比，COVID-19患者组细胞因子（IL-6、IL-4、IL-8、IL-10和TNF-α）表达水平更高。在COVID-19患者组中，重症患者的淋巴细胞亚群计数低于轻症患者。此外，重症患者的IL-6水平高于轻症患者。多因素logistic回归分析证实，IL-6（比值比：0.985[0.977-0.993]）、CD3 T细胞（比值比：1.007[1.004-1.010]）、CD8 T细胞（比值比：1.016[1.009-1.023]）和CD19 B细胞（比值比：1.011[1.002-1.020]）可独立预测疾病的严重进展。ROC曲线结果显示，重症COVID-19患者淋巴细胞的AUC为0.8686（0.8112-0.9260），CD3 T细胞为0.8762（0.8237-0.9287），CD8 T细胞为0.7963（0.7287-0.8638），CD4 T细胞为0.8600（0.8036-0.9164），CD19 B细胞为0.7217（0.6434-0.8001），NK细胞为0.6492（0.5627-0.7357），年龄为0.6699（0.5877-0.7521），糖尿病为0.5991（0.5125-0.6857），IL-6为0.7241（0.6479-0.8003）。此外，不同因素（CD3 T细胞、年龄、IL-6）的ROC曲线AUC为0.9031（0.8580-0.9483）。
本研究表明，COVID-19患者淋巴细胞亚群减少，炎性因子IL-6升高，尤其在重症组。因此，淋巴细胞亚群计数（CD3 T细胞）和炎性细胞因子含量（IL-6）可作为评估COVID-19严重程度和制定治疗方案疗效的预测指标。
