Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China
Open accessAbstract
Background: In December 2019, coronavirus 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China. Methods: Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from 10 January to 12 February 2020 were collected and analyzed. The data on laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between patients with severe and nonsevere infection. Results: Of the 452 patients with COVID-19 recruited, 286 were diagnosed as having severe infection. The median age was 58 years and 235 were male. The most common symptoms were fever, shortness of breath, expectoration, fatigue, dry cough, and myalgia. Severe cases tend to have lower lymphocyte counts, higher leukocyte counts and neutrophil-lymphocyte ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines. The number of T cells significantly decreased, and were more impaired in severe cases. Both helper T (Th) cells and suppressor T cells in patients with COVID-19 were below normal levels, with lower levels of Th cells in the severe group. The percentage of naive Th cells increased and memory Th cells decreased in severe cases. Patients with COVID-19 also have lower levels of regulatory T cells, which are more obviously decreased in severe cases. Conclusions: The novel coronavirus might mainly act on lymphocytes, especially T lymphocytes. Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis, and treatment of COVID-19.
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Severe COVID-19 is characterized by increased circulating neutrophils and decreased lymphocytes.
“An increase in circulating neutrophils versus a decrease in lymphocytes has been appreciated as a hallmark of severe COVID-19”
From COVID-19 and the human innate immune system (2021) · cites this paper as Qin et al., 2020
Most patients with severe COVID-19 have substantially elevated serum levels of proinflammatory cytokines and chemokines, which contribute to pneumonia, cytokine storm, ARDS, sepsis and coagulopathy.
“The majority of patients with severe COVID-19 demonstrate substantially elevated serum levels of proinflammatory cytokines and chemokines, including IL-6, IL-1β, IL-2, IL-8, IL-17, G-CSF, GM-CSF, CXCL10, CCL2, CCL3 and TNF49,54,68.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [68]
Patients infected with SARS-CoV-2 present elevated levels of IL-6, IL-10, IL-1β, INF-γ, CCL2, TNF-α, CXCL10, CCL7, IL-1 receptor antagonist and IL-2 receptor, supposedly associated with disease severity.
“Patients infected with SARS-CoV-2 present elevated levels of IL-6, IL-10, IL-1β, INF-γ, CCL2, TNF-α, CXCL10, CCL7, IL-1 receptor antagonist and IL-2 receptor, supposedly associated with disease severity [9, 98–105].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [102]
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- Authors
- Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S., Tao, Y., Xie, C., Ma, K., Shang, K., Wang, W., & Tian, D.-S.
- Affiliations
- Tongji Hospital (CN)
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Corresponding author
- Tian, Dai-Shi
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-03-12
- Volume
- 71
- Issue
- 15
- Pages
- 762-768
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC7108125
- OpenAlex
- W3009859788
- Cited by
- 4,775
- References
- 18
- Citations by year
- 2026: 49 · 2025: 143 · 2024: 294 · 2023: 497 · 2022: 859 · 2021: 1417 · 2020: 1510 · 2019: 2 · 2018: 1 · 2014: 1
- FWCI
- 140.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pandemic, SARS-CoV-2, immune dysregulation, lymphocyte subsets, neutrophil-to-lymphocyte ratio, T cells, regulatory T cells, T helper cells, naive T cells, memory T cells, inflammatory cytokines, infection biomarkers, severe COVID-19, neutrophilic inflammation
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, Aged, 80 and over, China, Cough, Female, Fever, Hospitalization, Humans, Leukocyte Count, Lymphocytes, Male, Middle Aged, Monocytes, Neutrophils, Pneumonia, Viral, Retrospective Studies, Cytokines, Critical Illness, Coronavirus Infections, Young Adult, Pandemics
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