tetano
Editor, Senior Moderator
Infect Dis Poverty
. 2020 Nov 25;9(1):161.
doi: 10.1186/s40249-020-00780-6.
Increased circulating level of interleukin-6 and CD8 [SUP]+[/SUP] T cell exhaustion are associated with progression of COVID-19
Peng-Hui Yang[SUP] 1 [/SUP], Yi-Bo Ding[SUP] 2 [/SUP], Zhe Xu[SUP] 3 [/SUP], Rui Pu[SUP] 2 [/SUP], Ping Li[SUP] 2 [/SUP], Jin Yan[SUP] 1 [/SUP], Ji-Luo Liu[SUP] 2 [/SUP], Fan-Ping Meng[SUP] 3 [/SUP], Lei Huang[SUP] 3 [/SUP], Lei Shi[SUP] 3 [/SUP], Tian-Jun Jiang[SUP] 3 [/SUP], En-Qiang Qin[SUP] 3 [/SUP], Min Zhao[SUP] 3 [/SUP], Da-Wei Zhang[SUP] 3 [/SUP], Peng Zhao[SUP] 3 [/SUP], Ling-Xiang Yu[SUP] 1 [/SUP], Zhao-Hai Wang[SUP] 1 [/SUP], Zhi-Xian Hong[SUP] 1 [/SUP], Zhao-Hui Xiao[SUP] 1 [/SUP], Qing Xi[SUP] 1 [/SUP], De-Xi Zhao[SUP] 1 [/SUP], Peng Yu[SUP] 1 [/SUP], Cai-Zhong Zhu[SUP] 3 [/SUP], Zhu Chen[SUP] 3 [/SUP], Shao-Geng Zhang[SUP] 4 [/SUP], Jun-Sheng Ji[SUP] 5 [/SUP], Fu-Sheng Wang[SUP] 6 [/SUP], Guang-Wen Cao[SUP] 7 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) is pandemic. It is critical to identify COVID-19 patients who are most likely to develop a severe disease. This study was designed to determine the clinical and epidemiological features of COVID-19 patients associated with the development of pneumonia and factors associated with disease progression.
Methods: Seventy consecutive patients with etiologically confirmed COVID-19 admitted to PLA General Hospital in Beijing, China from December 27, 2019 to March 12, 2020 were enrolled in this study and followed-up to March 16, 2020. Differences in clinical and laboratory findings between COVID-19 patients with pneumonia and those without were determined by the χ[SUP]2[/SUP] test or the Fisher exact test (categorical variables) and independent group t test or Mann-Whitney U test (continuous variables). The Cox proportional hazard model and Generalized Estimating Equations were applied to evaluate factors that predicted the progression of COVID-19.
Results: The mean incubation was 8.67 (95% confidence interval, 6.78-10.56) days. Mean duration from the first test severe acute respiratory syndrome coronavirus 2-positive to conversion was 11.38 (9.86-12.90) days. Compared to pneumonia-free patients, pneumonia patients were 16.5 years older and had higher frequencies of having hypertension, fever, and cough and higher circulating levels of neutrophil proportion, interleukin-6, low count (< 190/?l) of CD8[SUP]+[/SUP] T cells, and neutrophil/lymphocyte ratio. Thirteen patients deteriorated during hospitalization. Cox regression analysis indicated that older age and higher serum levels of interleukin-6, C-reactive protein, procalcitonin, and lactate at admission significantly predicted the progression of COVID-19. During hospitalization, circulating counts of T lymphocytes, CD4[SUP]+[/SUP] T cells, and CD8[SUP]+[/SUP] T cells were lower, whereas neutrophil proportion, neutrophil/lymphocyte ratio, and the circulating levels of interleukin-6, C-reactive protein, and procalcitonin were higher, in pneumonia patients than in pneumonia-free patients. CD8[SUP]+[/SUP] lymphocyte count in pneumonia patients did not recover when discharged.
Conclusions: Older age and higher levels of C-reactive protein, procalcitionin, interleukin-6, and lactate might predict COVID-19 progression. T lymphocyte, especially CD8[SUP]+[/SUP] cell-mediated immunity is critical in recovery of COVID-19. This study may help in predicting disease progression and designing immunotherapy for COVID-19.
Keywords: CD8+ T cell exhaustion; COVID-19; Interleukin-6; Progression; Prospective case series.
. 2020 Nov 25;9(1):161.
doi: 10.1186/s40249-020-00780-6.
Increased circulating level of interleukin-6 and CD8 [SUP]+[/SUP] T cell exhaustion are associated with progression of COVID-19
Peng-Hui Yang[SUP] 1 [/SUP], Yi-Bo Ding[SUP] 2 [/SUP], Zhe Xu[SUP] 3 [/SUP], Rui Pu[SUP] 2 [/SUP], Ping Li[SUP] 2 [/SUP], Jin Yan[SUP] 1 [/SUP], Ji-Luo Liu[SUP] 2 [/SUP], Fan-Ping Meng[SUP] 3 [/SUP], Lei Huang[SUP] 3 [/SUP], Lei Shi[SUP] 3 [/SUP], Tian-Jun Jiang[SUP] 3 [/SUP], En-Qiang Qin[SUP] 3 [/SUP], Min Zhao[SUP] 3 [/SUP], Da-Wei Zhang[SUP] 3 [/SUP], Peng Zhao[SUP] 3 [/SUP], Ling-Xiang Yu[SUP] 1 [/SUP], Zhao-Hai Wang[SUP] 1 [/SUP], Zhi-Xian Hong[SUP] 1 [/SUP], Zhao-Hui Xiao[SUP] 1 [/SUP], Qing Xi[SUP] 1 [/SUP], De-Xi Zhao[SUP] 1 [/SUP], Peng Yu[SUP] 1 [/SUP], Cai-Zhong Zhu[SUP] 3 [/SUP], Zhu Chen[SUP] 3 [/SUP], Shao-Geng Zhang[SUP] 4 [/SUP], Jun-Sheng Ji[SUP] 5 [/SUP], Fu-Sheng Wang[SUP] 6 [/SUP], Guang-Wen Cao[SUP] 7 [/SUP]
Affiliations
- PMID: 33239109
- DOI: 10.1186/s40249-020-00780-6
Abstract
Background: Coronavirus disease 2019 (COVID-19) is pandemic. It is critical to identify COVID-19 patients who are most likely to develop a severe disease. This study was designed to determine the clinical and epidemiological features of COVID-19 patients associated with the development of pneumonia and factors associated with disease progression.
Methods: Seventy consecutive patients with etiologically confirmed COVID-19 admitted to PLA General Hospital in Beijing, China from December 27, 2019 to March 12, 2020 were enrolled in this study and followed-up to March 16, 2020. Differences in clinical and laboratory findings between COVID-19 patients with pneumonia and those without were determined by the χ[SUP]2[/SUP] test or the Fisher exact test (categorical variables) and independent group t test or Mann-Whitney U test (continuous variables). The Cox proportional hazard model and Generalized Estimating Equations were applied to evaluate factors that predicted the progression of COVID-19.
Results: The mean incubation was 8.67 (95% confidence interval, 6.78-10.56) days. Mean duration from the first test severe acute respiratory syndrome coronavirus 2-positive to conversion was 11.38 (9.86-12.90) days. Compared to pneumonia-free patients, pneumonia patients were 16.5 years older and had higher frequencies of having hypertension, fever, and cough and higher circulating levels of neutrophil proportion, interleukin-6, low count (< 190/?l) of CD8[SUP]+[/SUP] T cells, and neutrophil/lymphocyte ratio. Thirteen patients deteriorated during hospitalization. Cox regression analysis indicated that older age and higher serum levels of interleukin-6, C-reactive protein, procalcitonin, and lactate at admission significantly predicted the progression of COVID-19. During hospitalization, circulating counts of T lymphocytes, CD4[SUP]+[/SUP] T cells, and CD8[SUP]+[/SUP] T cells were lower, whereas neutrophil proportion, neutrophil/lymphocyte ratio, and the circulating levels of interleukin-6, C-reactive protein, and procalcitonin were higher, in pneumonia patients than in pneumonia-free patients. CD8[SUP]+[/SUP] lymphocyte count in pneumonia patients did not recover when discharged.
Conclusions: Older age and higher levels of C-reactive protein, procalcitionin, interleukin-6, and lactate might predict COVID-19 progression. T lymphocyte, especially CD8[SUP]+[/SUP] cell-mediated immunity is critical in recovery of COVID-19. This study may help in predicting disease progression and designing immunotherapy for COVID-19.
Keywords: CD8+ T cell exhaustion; COVID-19; Interleukin-6; Progression; Prospective case series.