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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 2020More...
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
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