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. 2005 Nov;9(6):323-30.
doi: 10.1016/j.ijid.2004.07.014. Epub 2005 Aug 10.

Effects of severe acute respiratory syndrome (SARS) coronavirus infection on peripheral blood lymphocytes and their subsets

Zhongping He  1 , Chunhui Zhao, Qingming Dong, Hui Zhuang, Shujing Song, Guoai Peng, Dominic E Dwyer
Affiliations

Effects of severe acute respiratory syndrome (SARS) coronavirus infection on peripheral blood lymphocytes and their subsets

Zhongping He et al. Int J Infect Dis. 2005 Nov.

Abstract

Introduction: Severe acute respiratory syndrome (SARS) caused large outbreaks of atypical pneumonia in 2003, with the largest localized outbreak occurring in Beijing, China. Lymphopenia was prominent amongst the laboratory abnormalities reported in acute SARS.

Methods: The effect of SARS on peripheral blood lymphocytes and their subsets was examined in 271 SARS coronavirus-infected individuals.

Results: There was a significant decrease in the CD45+, CD3+, CD4+, CD8+, CD19+ and CD16+/56+ cell counts over the five weeks of the SARS illness although CD4+/CD8+ ratios did not change significantly. The lymphopenia was prolonged, reaching a nadir during days 7-9 in the second week of illness before returning towards normal after five weeks, with the lowest mean CD4+ cell count of 317 cellsx10(6)/L at day 7, and CD8+ cell count of 239 cellsx10(6)/L at day 8. Patients with more severe clinical illness, or patients who died, had significantly more profound CD4+ and CD8+ lymphopenia.

Discussion: Lymphopenia is a prominent part of SARS-CoV infection and lymphocyte counts may be useful in predicting the severity and clinical outcomes. Possible reasons for the SARS-associated lymphopenia may be direct infection of lymphocytes by SARS-CoV, lymphocyte sequestration in the lung or cytokine-mediated lymphocyte trafficking. There may also be immune-mediated lymphocyte destruction, bone marrow or thymus suppression, or apoptosis.

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Figures

Figure 1
Figure 1
Kinetics of CD45+, CD4+, CD8+, CD3+, CD19+ and CD16+56+ lymphocyte subsets (expressed as mean number of cells × 106/L) measured over the first five weeks of illness in laboratory-confirmed SARS patients and in otherwise healthy controls.
Figure 2
Figure 2
Kinetics of CD45+, CD19+, CD16+56+ lymphocytes (expressed as mean number of cells x 106/L) measured over the first 21 days of illness in laboratory-confirmed SARS patients and in otherwise healthy controls.
Figure 3
Figure 3
Kinetics of lymphocyte subsets (expressed as mean number of cells × 106/L) measured over the first five weeks of illness in non-severe and severe laboratory-confirmed SARS patients, and in otherwise healthy controls.
See this image and copyright information in PMC

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