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Study of the Lymphocyte Change Between COVID-19 and Non-COVID-19 Pneumonia Cases Suggesting Other Factors Besides Uncontrolled Inflammation Contributed to Multi-Organ Injury

22 Pages Posted: 30 Mar 2020

See all articles by Yishan Zheng

Yishan Zheng

Nanjing University of Chinese Medicine (NJUCM) - Department of Critical Medicine

Zhen Huang

Nanjing University - State Key Laboratory of Pharmaceutical Biotechnology

Guoping Yin

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Xia Zhang

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Wei Ye

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Zhiliang Hu

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Chunmei Hu

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Hongxia Wei

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Yi Zeng

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Yun Chi

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Cong Cheng

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Feishen Lin

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Hu Lu

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Lingyan Xiao

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Yan Song

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Chunming Wang

Macau University of Science and Technology - State Key Laboratory of Quality Research in Chinese Medicine

Yongxiang Yi

Nanjing University of Chinese Medicine (NJUCM) - Nanjing Infectious Disease Center

Lei Dong

Nanjing University - State Key Laboratory of Pharmaceutical Biotechnology; Nanjing University - Chemistry and Biomedicine Innovative Center

More...

Abstract

Background: The corona virus disease 2019 (COVID-19) shows unusually high transmission rate and unique clinical characteristics, with key pathological mechanism remaining unclear. Here, we analysed the laboratory data based on clinical samples from COVID-19 patients, in parallel comparison with non-COVID-19 pneumonia cases, in an attempt to elucidate the key pathological features of COVID-19 during its infection of the human body.

Methods: We analysed biochemical indices and lymphocyte subpopulation in COVID-19 patients, and compare these data from non-COVID-19 pneumonia cases. Correlation analysis was performed between leukocyte subgroups count and biochemical indexes in COVID-19 patients.

Results: The study enrolled 110 patients, comprising 88 COVID-19 patients and 22 non-COVID-19 pneumonia cases. We observed significant differences, including abnormal biochemical indices (CRP, LDH, AST, eGFR, and sodium ion concentration) and reduced lymphocyte subsets count, between the COVID-19 patients and non-COVID-19-caused pneumonia cases. Correlation analysis indicates that the count for lymphocyte subsets-but not that for neutrophils and monocytes-exhibits a significant negative correlation with biochemical indices relating to organ injury, in the COVID-19 infected patients.

Conclusions: The study indicates significantly different clinical features between 2019 novel coronavirus (2019-nCoV)-caused and non-2019-nCoV-caused pneumonia, especially in terms of lymphocytopenia and organ injury. Notably, correlation analysis demonstrates that tissue damage in COVID-19 patients is attributed to virus infection itself rather than uncontrolled inflammatory responses ("cytokine storm"). These findings provide new insights for developing efficient therapeutic strategies against COVID-19 infection.

Funding Statement: This study was funded by the Young Medical Talents of Jiangsu Province (QNRC2016056), the fifth period "333 high-level personnel training project" in Jiangsu Provience (2016-III-0084), the National Natural Science Foundation of China (31971309 and 31671031), the Jiangsu Province Funds for Distinguished Young Scientists (BK20170015).

Declaration of Interests: None declared.

Ethics Approval Statement: This study was approved by the ethics committee of the Second Hospital of Nanjing, with written informed consent obtained from each patient.

Keywords: COVID-19; non-COVID-19 pneumonia; lymphocytopenia; organ injury

Suggested Citation

Zheng, Yishan and Huang, Zhen and Yin, Guoping and Zhang, Xia and Ye, Wei and Hu, Zhiliang and Hu, Chunmei and Wei, Hongxia and Zeng, Yi and Chi, Yun and Cheng, Cong and Lin, Feishen and Lu, Hu and Xiao, Lingyan and Song, Yan and Wang, Chunming and Yi, Yongxiang and Dong, Lei, Study of the Lymphocyte Change Between COVID-19 and Non-COVID-19 Pneumonia Cases Suggesting Other Factors Besides Uncontrolled Inflammation Contributed to Multi-Organ Injury (3/12/2020). Available at SSRN: https://ssrn.com/abstract=3555267 or http://dx.doi.org/10.2139/ssrn.3555267

Yishan Zheng

Nanjing University of Chinese Medicine (NJUCM) - Department of Critical Medicine

China

Zhen Huang

Nanjing University - State Key Laboratory of Pharmaceutical Biotechnology

Nanjing, 210023
China

Guoping Yin

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Xia Zhang

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Wei Ye

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Zhiliang Hu

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Chunmei Hu

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Hongxia Wei

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Yi Zeng

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Yun Chi

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Cong Cheng

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Feishen Lin

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Hu Lu

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Lingyan Xiao

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Yan Song

Nanjing University of Chinese Medicine (NJUCM) - Department of Anesthesiology, Tuberculosis and Infectious Disease

Nanjing
China

Chunming Wang

Macau University of Science and Technology - State Key Laboratory of Quality Research in Chinese Medicine

Macau
China

Yongxiang Yi

Nanjing University of Chinese Medicine (NJUCM) - Nanjing Infectious Disease Center ( email )

China

Lei Dong (Contact Author)

Nanjing University - State Key Laboratory of Pharmaceutical Biotechnology ( email )

Nanjing, 210023
China

Nanjing University - Chemistry and Biomedicine Innovative Center ( email )

Nanjing
China

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