Department of Infectious Disease, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania.
Doctoral School of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania.
Int J Mol Sci. 2024 Nov 6;25(22):11921. doi: 10.3390/ijms252211921.
Studies suggest that the dynamic changes in cellular response might correlate with disease severity and outcomes in SARS-CoV-2 patients. The study aimed to investigate the dynamic changes of lymphocyte subsets in patients with COVID-19. In this regard, 53 patients with COVID-19 were prospectively included, classified as mild, moderate, and severe. The peripheral lymphocyte profiles (LyT, LyB, and NK cells), as well as CD4+/CD8+, CD3+/CD19+, CD3+/NK and CD19+/NK ratios, and their dynamic changes during hospitalization and correlation with disease severity and outcome were assessed. We found significant differences in CD3+ lymphocytes between severity groups ( < 0.0001), with significantly decreased CD3+CD4+ and CD3+CD8+ in patients with severe disease ( < 0.0001 and = 0.048, respectively). Lower CD3+/CD19+ and CD3+/NK ratios among patients with severe disease ( = 0.019 and = 0.010, respectively) were found. The dynamic changes of lymphocyte subsets showed a significant reduction in NK cells (%) and a significant increase in CD3+CD4+ and CD3+CD8+ cells in patients with moderate and severe disease. The ROC analysis on the relationship between CD3+ cells and fatal outcome yielded an AUC of 0.723 (95% CI 0.583-0.837; = 0.007), while after addition of age and SpO, ferritin and NLR, the AUC significantly improved to 0.927 (95%CI 0.811-0.983), < 0.001 with a sensitivity of 90.9% (95% CI 58.7-99.8%) and specificity of 85.7% (95% CI 69.7-95.2%). The absolute number of CD3+ lymphocytes might independently predict fatal outcomes in COVID-19 patients and T-lymphocyte subset evaluation in high-risk patients might be useful in estimating disease progression.
研究表明，细胞反应的动态变化可能与 SARS-CoV-2 患者的疾病严重程度和结局相关。本研究旨在探讨 COVID-19 患者淋巴细胞亚群的动态变化。为此，前瞻性纳入了 53 例 COVID-19 患者，分为轻症、中度和重症。评估了外周血淋巴细胞谱（LyT、LyB 和 NK 细胞）以及 CD4+/CD8+、CD3+/CD19+、CD3+/NK 和 CD19+/NK 比值在住院期间的动态变化及其与疾病严重程度和结局的关系。我们发现严重程度组之间 CD3+淋巴细胞有显著差异（<0.0001），重症患者 CD3+CD4+和 CD3+CD8+明显降低（<0.0001 和=0.048）。重症患者 CD3+/CD19+和 CD3+/NK 比值较低（=0.019 和=0.010）。中度和重度疾病患者的淋巴细胞亚群动态变化显示 NK 细胞（%）显著减少，CD3+CD4+和 CD3+CD8+细胞显著增加。CD3+细胞与死亡结局关系的 ROC 分析显示 AUC 为 0.723（95%CI 0.583-0.837；=0.007），而在加入年龄、SpO2、铁蛋白和 NLR 后，AUC 显著提高至 0.927（95%CI 0.811-0.983），<0.001，灵敏度为 90.9%（95%CI 58.7-99.8%），特异性为 85.7%（95%CI 69.7-95.2%）。CD3+淋巴细胞的绝对数可能独立预测 COVID-19 患者的死亡结局，高危患者的 T 淋巴细胞亚群评估可能有助于估计疾病进展。
