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Dysregulation of Immune Response in Patients with COVID-19 in Wuhan, China

18 Pages Posted: 2 Mar 2020

See all articles by Chuan Qin

Chuan Qin

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

Luoqi Zhou

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

Ziwei Hu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

Shuoqi Zhang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Radiology

Sheng Yang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

Yu Tao

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory Diseases

Cuihong Xie

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Emergency Medicine

Ke Ma

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Infectious Disease

Ke Shang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

Wei Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

Dai-Shi Tian

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

More...

Abstract

Background: In December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan and rapidly spread throughout China. The immune response is likely to be highly involved in the pathological process of coronavirus disease 2019 (COVID-19). However, information on specific changes of immune response in COVID-19 are limited.

Methods: Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from January 10 to February 12, 2020, were collected and analyzed. The expression of lymphocytes, lymphocyte subsets, infection related biomarkers and inflammatory cytokines were analyzed and compared between severe cases and non-severe patients.

Findings: Of the 452 patients with COVID-19 recruited from January 10 to February 12, 2020, 286 were diagnosed as severe infection. The median age was 58 years and 235 were male. 201 patients had chronic diseases and a higher percentage in the severe cases. The most common symptoms were fever, shortness of breath, expectoration, and fatigue. Severe cases tend to have higher white blood cell and neutrophil lymphopenia ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most of severe cases demonstrated elevated levels of infection-related biomarkers, and inflammatory cytokines. The numbers of B cells, T cells and NK cells was significantly decreased in patients with COVID-19, and more severely decreased in the severe cases. T cells were shown to be most affected by SARS-CoV-2, and more hampered in severe cases. Both helper T cells and suppressor T cells in patients with COVID-19 were below normal levels. Helper T cells tend to be more affected in severe cases. The percentage of naïve helper T cells increased and memory helper T cells decreased in severe cases. Patients with COVID-19 have lower level of regulatory T cells, and more obviously damaged in severe cases.

Interpretation: SARS-CoV-2 might mainly act on lymphocytes, especially T lymphocytes, and induce a cytokine storm in the body, generate a series of immune responses. Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis and treatment of COVID-19.

Funding Statement: None.

Declaration of Interests: All authors declare no competing interests.

Ethics Approval Statement: The study was performed in accordance with Tongji Hospital Ethics Committee (IRB ID: TJ-C20200121). Written informed consent was waived by the Ethics Commission of the designated hospital for emerging infectious disease.

Keywords: lymphocyte; cytokine storm; lymphocyte subsets

Suggested Citation

Qin, Chuan and Zhou, Luoqi and Hu, Ziwei and Zhang, Shuoqi and Yang, Sheng and Tao, Yu and Xie, Cuihong and Ma, Ke and Shang, Ke and Wang, Wei and Tian, Dai-Shi, Dysregulation of Immune Response in Patients with COVID-19 in Wuhan, China (February 17, 2020). Available at SSRN: https://ssrn.com/abstract=3541136 or http://dx.doi.org/10.2139/ssrn.3541136

Chuan Qin

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

China

Luoqi Zhou

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

China

Ziwei Hu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

China

Shuoqi Zhang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Radiology

No.1095 Jiefang Avenue
Wuhan, 430030
China

Sheng Yang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

China

Yu Tao

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory Diseases

China

Cuihong Xie

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Emergency Medicine

Wuhan
China

Ke Ma

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Infectious Disease ( email )

Wuhan, 430030
China

Ke Shang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

China

Wei Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology

China

Dai-Shi Tian (Contact Author)

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Neurology ( email )

China

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