Relationships among lymphocyte subsets, cytokines, and the pulmonary inflammation index in coronavirus (COVID-19) infected patients

Abstract

We explored the relationships between lymphocyte subsets, cytokines, pulmonary inflammation index (PII) and disease evolution in patients with (corona virus disease 2019) COVID-19. A total of 123 patients with COVID-19 were divided into mild and severe groups. Lymphocyte subsets and cytokines were detected on the first day of hospital admission and lung computed tomography results were quantified by PII. Difference analysis and correlation analysis were performed on the two groups. A total of 102 mild and 21 severe patients were included in the analysis. There were significant differences in cluster of differentiation 4 (CD4⁺ T), cluster of differentiation 8 (CD8⁺ T), interleukin 6 (IL-6), interleukin 10 (IL-10) and PII between the two groups. There were significant positive correlations between CD4⁺ T and CD8⁺ T, IL-6 and IL-10 in the mild group (r² = 0·694, r ² = 0·633, respectively; P < 0·01). After 'five-in-one' treatment, all patients were discharged with the exception of the four who died. Higher survival rates occurred in the mild group and in those with IL-6 within normal values. CD4⁺ T, CD8⁺ T, IL-6, IL-10 and PII can be used as indicators of disease evolution, and the PII can be used as an independent indicator for disease progression of COVID-19.

Keywords: coronavirus infected disease; cytokines; disease classification; lymphocyte subsets; pulmonary inflammatory index.

Fig 1

Typical CT images of patients with mild 2019 novel coronavirus pneumonia (COVID‐19). Patchy ground glass opacities can be seen in the apical and posterior segments of the right upper lobe, the posterior basal segment of the right lower lobe, the medial segment of the right middle lobe, the lingual segment of the left upper lobe, the anterior inner basal segment of the left lower lobe, the posterior basal segment, and the subpleural of outer basal segment of the left lower lobe. [Colour figure can be viewed at http://www.wileyonlinelibrary.com/]

Fig 2

Typical CT images of patients with severe 2019 novel coronavirus pneumonia (COVID‐19). Strip‐like consolidation shadows and patchy ground glass‐like density shadows can be seen in the apical and posterior segment of the upper lobe of both lungs, tongue segment of the left upper lobe, and the lower lobe of both lungs with a fuzzy boundary, mainly distributed under the pleura of both lungs when the patient was in severe condition. [Colour figure can be viewed at http://www.wileyonlinelibrary.com/]

Fig 3

Kaplan–Meier curves of mild and severe patients, within normal and above normal values IL‐6 patients. (A) Kaplan–Meier curve of mild and severe group; (B) Kaplan–Meier curve of within normal and above normal IL‐6 group; (C) Progression‐free curve of the mild group and within normal IL‐6 group. [Colour figure can be viewed at http://www.wileyonlinelibrary.com/]