The laboratory tests and host immunity of COVID-19 patients with different severity of illness
Feng Wang, Hongyan Hou, Ying Luo, Guoxing Tang, Shiji Wu, Min Huang, Weiyong Liu, Yaowu Zhu, Qun Lin, Liyan Mao, Minghao Fang, Huilan Zhang, Ziyong Sun
Feng Wang, Hongyan Hou, Ying Luo, Guoxing Tang, Shiji Wu, Min Huang, Weiyong Liu, Yaowu Zhu, Qun Lin, Liyan Mao, Minghao Fang, Huilan Zhang, Ziyong Sun
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Clinical Research and Public Health Immunology Infectious disease

The laboratory tests and host immunity of COVID-19 patients with different severity of illness

Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19), infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a severe outbreak throughout the world. The host immunity of COVID-19 patients is unknown.METHODS The routine laboratory tests and host immunity in COVID-19 patients with different severity of illness were compared after patient admission.RESULTS A total of 65 SARS-CoV-2–positive patients were classified as having mild (n = 30), severe (n = 20), and extremely severe (n = 15) illness. Many routine laboratory tests, such as ferritin, lactate dehydrogenase, and D-dimer, were increased in severe and extremely severe patients. The absolute numbers of CD4+ T cells, CD8+ T cells, and B cells were gradually decreased with increased severity of illness. The activation markers such as HLA-DR and CD45RO expressed on CD4+ and CD8+ T cells were increased in severe and extremely severe patients compared with mild patients. The costimulatory molecule CD28 had opposite results. The percentage of natural Tregs was decreased in extremely severe patients. The percentage of IFN-γ–producing CD8+ T cells was increased in both severe and extremely severe patients compared with mild patients. The percentage of IFN-γ–producing CD4+ T cells was increased in extremely severe patients. IL-2R, IL-6, and IL-10 were all increased in extremely severe patients. The activation of DC and B cells was decreased in extremely severe patients.CONCLUSION The number and function of T cells are inconsistent in COVID-19 patients. The hyperfunction of CD4+ and CD8+ T cells is associated with the pathogenesis of extremely severe SARS-CoV-2 infection.FUNDING This work was funded by the National Mega Project on Major Infectious Disease Prevention (2017ZX10103005-007) and the Fundamental Research Funds for the Central Universities (2019kfyRCPY098).

Authors

Feng Wang, Hongyan Hou, Ying Luo, Guoxing Tang, Shiji Wu, Min Huang, Weiyong Liu, Yaowu Zhu, Qun Lin, Liyan Mao, Minghao Fang, Huilan Zhang, Ziyong Sun

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Figure 2

The phenotypes and subsets of T cells.

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The phenotypes and subsets of T cells. (A–E) FACS dot plots showing the ...
(A–E) FACS dot plots showing the expression of HLA-DR (A), CD28 (B), PD-1 (C), Tim-3 (D) on CD4+ and CD8+ T cells, and the expression of CD45RA and CD45RO (E) on CD4+ T cells in representative patients with different severity of illness. (F) FACS dot plots showing the gating of Tregs, and the expression of CD45RA and CD45RO on Tregs in representative patients with different severity of illness. (G) The percentages of HLA-DR+, CD28+, PD-1+, and Tim-3+ cells in CD4+ or CD8+ T cells, the percentage of CD45RO+ cells in CD4+ T cells, the percentage of Tregs in lymphocytes, and the percentage of CD45RA+ Tregs in lymphocytes in patients with different groups are shown in graphs (mean ± SD). *P < 0.05, **P < 0.01, ***P < 0.001 (1-way ANOVA).