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Heliyon . The immune inflammation factors associated with disease severity and poor prognosis in patients with COVID-19: A retrospective cohort stu

tetano

Editor, Senior Moderator
Heliyon


. 2023 Dec 12;10(1):e23583.
doi: 10.1016/j.heliyon.2023.e23583. eCollection 2024 Jan 15. The immune inflammation factors associated with disease severity and poor prognosis in patients with COVID-19: A retrospective cohort study

Yanli Kang[SUP] 1 [/SUP], Shifa Lu[SUP] 2 [/SUP], Ruifang Zhong[SUP] 1 [/SUP], Jianbin You[SUP] 1 [/SUP], Jiahao Chen[SUP] 1 [/SUP], Ling Li[SUP] 1 [/SUP], Rongbin Huang[SUP] 2 [/SUP], Yanyan Xie[SUP] 3 [/SUP], Falin Chen[SUP] 1 [/SUP], Jinhua Chen[SUP] 1 [/SUP], Liangyuan Chen[SUP] 1 [/SUP]



Affiliations
Abstract

Coronavirus disease 2019 (COVID-19) is associated with immune dysregulation and cytokine storm. It is essential to explore the immune response characteristics of peripheral circulation in COVID-19 patients to reveal pathogenesis and predict disease progression. In this study, the levels of total immunoglobulins (IgG, IgM, IgA), complement (C3, C4),lymphocyte subsets (CD3[SUP]+[/SUP] cell,CD4+ cell,CD8+ cell, NK cell, CD19[SUP]+[/SUP] cell and CD45[SUP]+[/SUP] cell) and cytokines (IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IL-12p, IL-1β, TNF-α, IFN-α and IFN-γ) were retrospectively analyzed in COVID-19 patients. A total of 513 patients were enrolled in this study, cases were distributed according to clinical status as mild or moderate (n = 212), severe survivors (n = 197) and severe non-survivors (n = 104). IL-6, IL-8, IL-10 and IFN-γ were increased in severe patients compared with non-severe patients, despite decreased CD45[SUP]+[/SUP] cell, CD3[SUP]+[/SUP] cell, CD4[SUP]+[/SUP] cell, CD8[SUP]+[/SUP] cell, CD19[SUP]+[/SUP] cell, and NK cell. Compared with severe survivors, the levels of L-6, IL-8 and IL-10 in non-survivors increased significantly, and levels of C3, CD45[SUP]+[/SUP] cell, CD3[SUP]+[/SUP] cell,CD4+ cell,CD8+ cell, and NK cell decreased. Moreover, age, IL-8, IL-10, CD8+cells and NK cell were independent risk factors for the severity of COVID-19. Multivariable regression showed increasing odds ratio of in-hospital death associated with tumor, older age, higher IL-8 level, and decreasing odds ratio of in-hospital death associated with increased levels of CD8+cell and NK cell. Finally, patients with tumor, or high IL-6 or high IL-10 expression and lower CD8[SUP]+[/SUP] or lower NK levels exhibited a significantly shorter survival time. In conclusion, our study provides findings of the immunological characteristics associated with disease severity to predict the progression of COVID-19. The immune inflammation factors, such as IL-6, IL-8, IL-10, CD8[SUP]+[/SUP] cell and NK cell, could serve as excellent biomarkers for monitoring or predicting COVID-19 progression therapeutic to COVID-19 patients.

Keywords: CD8+; COVID-19; IL-10; IL-6; Immunological characteristics.

 
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