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. 2020 May 11;221(11):1762-1769.
doi: 10.1093/infdis/jiaa150.

Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia

Fan Wang  1 , Jiayan Nie  1 , Haizhou Wang  1 , Qiu Zhao  1 , Yong Xiong  2 , Liping Deng  2 , Shihui Song  2 , Zhiyong Ma  2 , Pingzheng Mo  2 , Yongxi Zhang  2
Affiliations

Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia

Fan Wang et al. J Infect Dis. .

Abstract

Background: In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19.

Methods: The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed.

Results: Total lymphocytes, CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8+ T cells and CD4+/CD8+ ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8+ T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio were indicated as independent predictors of poor efficacy.

Conclusions: Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8+ T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy.

Keywords: COVID-19; lymphocyte subset; pneumonia.

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Figures

Figure 1.
Figure 1.
Comparison of peripheral lymphocyte subsets between COVID-19 pneumonia (CP) patients and healthy controls (HC). ***, P < .001; NS, not significant.
Figure 2.
Figure 2.
Peripheral lymphocyte subset levels and disease severity in COVID-19 pneumonia. *, P < .05; **; NS, not significant.
Figure 3.
Figure 3.
Correlation analysis of peripheral lymphocyte subset levels and inflammatory indicator levels in COVID-19 pneumonia patients. Solid line: fitted curve; dashed line: 95% confidence interval (CI) of the fitted curve. Abbreviations: ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; IL-6, interleukin-6.
Figure 4.
Figure 4.
Peripheral lymphocyte subset alteration in clinically responsive and nonresponsive patients with COVID-19 pneumonia before (before T) and after 1 week of treatment (after T). *, P < .05; ***, P < .001; NS, not significant.
Figure 5.
Figure 5.
Receiver operating characteristic (ROC) curve analysis of posttreatment alteration of peripheral lymphocyte subsets in predicting clinical efficacy in COVID-19 pneumonia.
See this image and copyright information in PMC

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