Matrix Analysis of Clinical Characteristics and Dynamic Observation of Immunological Features in 90 Cases of COVID-19
30 Pages Posted: 2 Apr 2020More...
Background: The correlation matrix in COVID-19 clinical characteristics especially immunological features of peripheral blood is blank. And the dynamic changes of lymphocyte subsets and cytokines in clinical course and prognosis of COVID-19 had not been elucidated.
Methods: We extracted data regarding 90 patients with laboratory-confirmed COVID-19 from in mainland China through February 28, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, prognosis, dynamic modifications of lymphocyte subsets and cytokines profiles were all collected. Correlation matrix analysis was performed in these clinical characteristics.
Findings: Matrix research indicated that peripheral blood lymphocyte subsets were closely related to diagnosis type and prognosis. 41% mild COVID-19 patients appeared minor NK cell reduction, with IL-2 and TNF-α increased. However, all severe patients had Ts cell remarkable decreased, with a robust reduction of at least 2 other lymphocyte subsets, experience a cytokine storm characterized by IL-6 and IL-10. Furthermore, severe patients without mechanical ventilation showed T lymphocyte subsets decline and recovered within 14d, accompanied by the reduction of cytokines. But the NK and B cells slowly returned more than 21d. In contrast, all lymphocyte subsets of severe patients with mechanical ventilation were in lower level and difficult to recover, undergo uncontrolled cytokine storm. IL-6 and IL-10 were proportional to the intensity of the cytokine storm and best reflect the change of COVID-19.
Interpretation: Lymphocyte subsets and cytokines had closely related with diagnosis type, clinical therapy and prognosis of COVID-19. The continuous imbalance of lymphocyte subsets induced uncontrolled cytokine storm characterized by IL-6 and IL-10.
Funding Statement: None.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: This study was approved by the review committee of the National Health Commission. National Health Commission of the People's Republic of China has determined that collection and analysis of data on cases of infectious diseases and close contacts is part of the ongoing investigation of outbreaks in public health events and is therefore exempted from review board approval.
Keywords: COVID-19; SARS-CoV-2; lymphocyte subsets; cytokine storm; matrix analysis
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