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. 2021 Apr 9:14:1331-1340.
doi: 10.2147/JIR.S303117. eCollection 2021.

Decreased T Cell Levels in Critically Ill Coronavirus Patients: Single-Center, Prospective and Observational Study

Jingjing Xu  1 , Zhiyu Liu  2 , Haitao Liu  1 , Yunpeng Luo  3 , Kai Kang  3 , Xueting Li  1 , Wei Yang  3 , Dongsheng Fei  3 , Changsong Wang  1   3 , Kaijiang Yu  3
Affiliations

Decreased T Cell Levels in Critically Ill Coronavirus Patients: Single-Center, Prospective and Observational Study

Jingjing Xu et al. J Inflamm Res. .

Abstract

Background: Since Dec. 2019, the COVID-19 pandemic has been an outbreak. T cells play an important role in dealing with various disease-causing pathogens. However, the role of T cells played in COVID-19 patients is still unknown. Our study aimed to describe the immunologic state of the critically ill COVID-19 patients.

Methods: A total of 63 patients with confirmed COVID-19 pneumonia were admitted to the Department of Intensive Care Unit of the First Affiliated Hospital of Harbin Medical University. The immunologic characteristics (lymphocyte apoptosis, the expression of PD-1 and HLA-DR in T cells, T cell subset levels, redistribution and the production of inflammatory factors) as well as their laboratory parameters were compared between severe group and critical group.

Results: The level of T cells in peripheral blood was decreased in critical patients compared with that in severe patients, but the expression levels of PD-1 (CD4+: 24.71% VS 30.56%; CD8+: 33.05% VS 32.38%) and HLA-DR (T cells: 36.28% VS 27.44%; monocytes: 20.58% VS 23.83%) in T cells were not significantly changed, and apoptosis and necrosis were not different in lymphocytes (apoptosis: 1.04% VS 1.27%; necrosis: 0.67% VS 1.11%), granulocytes, or monocytes between those two groups.

Conclusion: There is severe immunosuppression in critically ill COVID-19 patients. Redistribution of T cells might be the main reason for lymphocytic decline. Decreasing the infiltration of T lymphocytes in the lung may be beneficial for the treatment of COVID-19.

Keywords: COVID-19; HLA-DR; PD-1; T lymphocytes; redistribution.

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Conflict of interest statement

The authors report no potential conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of COVID-19 patients.
Figure 2
Figure 2
The characteristics of T cell subset in peripheral blood, BALF and pleural effusion of COVID-19 patient. (A) The percentage of lymphocytes (T%), B cells (B%) or NK cells (NK%) in pleural effusion. (B) The percentage of lymphocytes (T%), B cells (B%) or NK cells (NK%) in BALF. (C) The characteristics of T cell subset in peripheral blood, BALF and pleural effusion.
See this image and copyright information in PMC

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