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. 2022 Jan-Dec:28:10760296221107889.
doi: 10.1177/10760296221107889.

COVID-19 Infection in Patients with Comorbidities: Clinical and Immunological Insight

Omnia El-Badawy  1 , Nahla M Elsherbiny  1 , Doaa Abdeltawab  2 , Doaa M Magdy  3 , Lamees M Bakkar  3 , Shimaa A Hassan  4 , Elham A Hassan  2 , Ahmed M Thabet  4 , Ahmed M Ashmawy  5 , Ehab F Moustafa  2 , Wael A Abbas  5 , Ahmad Bahieldeen Ahmad  6 , Amal Rayan  7 , Khaled Saad  8 , Amira Elhoufey  9 , Hosni A M Hussein  10 , Ali A Thabet  11 , Asmaa M Zahran  12
Affiliations

COVID-19 Infection in Patients with Comorbidities: Clinical and Immunological Insight

Omnia El-Badawy et al. Clin Appl Thromb Hemost. 2022 Jan-Dec.

Abstract

Aim: Our study's objectives were to study the clinical and laboratory characteristics that may serve as biomarkers for predicting disease severity, IL-10 levels, and frequencies of different T cell subsets in comorbid COVID-19 patients.

Methods: Sixty-two hospitalized COVID-19 patients with comorbidities were assessed clinically and radiologically. Blood samples were collected to assess the T lymphocyte subsets by flow cytometry and IL-10 levels by ELISA.

Results: The most common comorbidities observed in COVID-19 patients were diabetes mellitus (DM), hypertension, and malignancies. Common symptoms and signs included fever, cough, dyspnea, fatigue, myalgia, and sore throat. CRP, ferritin, D dimer, LDH, urea, creatinine, and direct bilirubin were significantly increased in patients than controls. Lymphocyte count and CD4+ and CD8+ T-cells were significantly decreased in comorbid COVID-19 patients, and CD25 and CD45RA expression were increased. CD4+ and CD8+ regulatory T cells (Tregs) and IL-10 levels were significantly decreased in patients.

Conclusions: Many parameters were found to be predictive of severity in the comorbid patients in our study. Significant reductions in the levels and activation of CD4+ and CD8+ T-cells were found. In addition, CD4+ and CD8+ Tregs were significant decreased in patients, probably pointing to a prominent role of CD8+ Tregs in dampening CD4+ T-cell activation.

Keywords: COVID-19; SARS-coV-2; comorbidities; t cells; tregs.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow cytometric detection of T cell subsets
Figure 2.
Figure 2.
Percentages of the different lymphocyte subsets in COVID-19 patients and the controls. The percentages of CD4+ and CD8+ lymphocytes were assessed in the lymphocyte population, and the percentages of CD25+, CD25high, CD45RA+ and regulatory T cells were calculated among the CD4+ and CD8+ lymphocytes.
Figure 3.
Figure 3.
Relations of the different lymphocyte subsets with COVID-19 severity. The percentages of CD4+ and CD8+ lymphocytes were assessed in the lymphocyte population, and the percentages of CD25+, CD25high and regulatory T cells were calculated among the CD4+ and CD8+ lymphocytes.
Figure 4.
Figure 4.
Receiver operating characteristics (ROC) curve comparing the performance of (A) LDH, direct bilirubin, prothrombin time (PT), and (B) some immune cells in the prediction of the severity level in COVID-19 patients.
Figure 5.
Figure 5.
Percentages of the different lymphocyte subsets in COVID-19 patients having cancer and those with other comorbidities. The percentages of CD4+ and CD8+ lymphocytes were assessed in the lymphocyte population, and the percentages of CD25+, CD25high, CD45RA+ and regulatory T cells were calculated among the CD4+ and CD8+ lymphocytes.
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