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Matrix Analysis of Clinical Characteristics and Dynamic Observation of Immunological Features in 90 Cases of COVID-19

30 Pages Posted: 2 Apr 2020

See all articles by Lei Wang

Lei Wang

Tongji University - Department of Medical Oncology

Ansheng Zou

Yantai Infectious Disease Hospital - Department of Critical Care Medicine

Jing Wang

Government of the People's Republic of China - Department of Anesthesiology

Qi Su

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Cijun Luo

Tongji University - Department of Cardio-Pulmonary Circulation

Xiaoli Sun

Tongji University - Department of Respiratory Medicine

Lei Lin

Tongji University - Department of Thoracic Surgery

Juanni Hu

Shanghai Jiao Tong University (SJTU) - Department of Pharmacy

Bin Huang

Third People's Hospital of Guangyuan City - Department of Respiratory Diseases

Fei Zhou

Tongji University - Department of Medical Oncology

Wei Li

Tongji University - Department of Medical Oncology

Xiaomei Gong

Tongji University - Department of Radiotherapy

Huiming Liu

People's Hospital of Dongchuan District - Department of Respiratory Medicine

Zhiqiang Zou

Yantai Infectious Disease Hospital - Department of Critical Care Medicine

Jian Ni

Shanghai Jiao Tong University (SJTU) - Department of Nephrology

Jun Liu

Shanghai Jiao Tong University (SJTU) - Department of Nephrology

Ruilan Wang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Zhenguo Liu

Weifang People's Hospital - Department of Anesthesiology

Caicun Zhou

Tongji University - Department of Medical Oncology

More...

Abstract

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

Suggested Citation

Wang, Lei and Zou, Ansheng and Wang, Jing and Su, Qi and Luo, Cijun and Sun, Xiaoli and Lin, Lei and Hu, Juanni and Huang, Bin and Zhou, Fei and Li, Wei and Gong, Xiaomei and Liu, Huiming and Zou, Zhiqiang and Ni, Jian and Liu, Jun and Wang, Ruilan and Liu, Zhenguo and Zhou, Caicun, Matrix Analysis of Clinical Characteristics and Dynamic Observation of Immunological Features in 90 Cases of COVID-19 (3/14/2020). Available at SSRN: https://ssrn.com/abstract=3556688 or http://dx.doi.org/10.2139/ssrn.3556688

Lei Wang (Contact Author)

Tongji University - Department of Medical Oncology

No. 507, Zheng Min Road
Shanghai, Shanghai
China

Ansheng Zou

Yantai Infectious Disease Hospital - Department of Critical Care Medicine

China

Jing Wang

Government of the People's Republic of China - Department of Anesthesiology

China

Qi Su

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine

Shanghai
China

Cijun Luo

Tongji University - Department of Cardio-Pulmonary Circulation

Shanghai
China

Xiaoli Sun

Tongji University - Department of Respiratory Medicine

Shanghai
China

Lei Lin

Tongji University - Department of Thoracic Surgery

Shanghai Shi
China

Juanni Hu

Shanghai Jiao Tong University (SJTU) - Department of Pharmacy

Shanghai
China

Bin Huang

Third People's Hospital of Guangyuan City - Department of Respiratory Diseases

Sichuan
China

Fei Zhou

Tongji University - Department of Medical Oncology

No. 507, Zheng Min Road
Shanghai, Shanghai
China

Wei Li

Tongji University - Department of Medical Oncology

No. 507, Zheng Min Road
Shanghai, Shanghai
China

Xiaomei Gong

Tongji University - Department of Radiotherapy

Shanghai
China

Huiming Liu

People's Hospital of Dongchuan District - Department of Respiratory Medicine

United States

Zhiqiang Zou

Yantai Infectious Disease Hospital - Department of Critical Care Medicine

China

Jian Ni

Shanghai Jiao Tong University (SJTU) - Department of Nephrology

Shanghai
China

Jun Liu

Shanghai Jiao Tong University (SJTU) - Department of Nephrology

Shanghai
China

Ruilan Wang

Shanghai Jiao Tong University (SJTU) - Department of Critical Care Medicine ( email )

Shanghai
China

Zhenguo Liu

Weifang People's Hospital - Department of Anesthesiology

Shandong
China

Caicun Zhou

Tongji University - Department of Medical Oncology ( email )

No. 507, Zheng Min Road
Shanghai, Shanghai
China

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