Clinical and prognostic value of cellular immune function in severe patients with coronavirus disease 2019 (COVID-19): A cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN You ^1,2 , LUO Yuchuan ^1,3 , WANG Kaijie ^4,5 , CAO Hui ^1,6 , LV Jianhong ^1,7 ,  ZHENG Jian ^1,6 ,  XU Yaqing ⁸

1. The 10^th Ward of Deparment of Infection, Renmin Hospital of Wuhan University, Wuhan, 430060, P.R.China;
2. Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, P.R.China;
3. Department of Respiratory, Renmin Hospital of Wuhan University, Wuhan, 430060, P.R.China;
4. The 23^rd Ward of Department of Infection, Renmin Hospital of Wuhan University, Wuhan, 430060, P.R.China;
5. Department of Respiratory, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, P.R.China;
6. Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan, 430060, P.R.China;
7. Department of Infection, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, P.R.China;
8. Department of Cadre Health, Renmin Hospital of Wuhan University, Wuhan, 430060, P.R.China;

Corresponding author：

ZHENG Jian, Email: 404498342@qq.com; XU Yaqing, Email: 15392885220@163.com

Keywords：

Coronavirus disease 2019 (COVID-19); cellular immunity; prognosis; cohort study

DOI：

10.7507/1007-4848.202003133

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the characteristics and prognostic value of cellular immune function in severe patients with coronavirus disease 2019 (COVID-19).Methods A cohort study was conducted to collect the clinical data of 119 severe patients admitted to the Renmin Hospital of Wuhan University (Eastern District) including 60 males (50.4%) and 59 females (49.6%), with an average age of 60.9±14.2 years. The primary endpoint of follow-up was death in the hospital, and the disease outcome classification was the secondary endpoint of follow-up within 30 days after admission. We analyzed the correlation between cellular immune function and COVID-19 prognosis.Results A total of 22 patients died during this process, and 47 patients were severe/critical during the follow-up period. The counts of CD3⁺, CD4⁺, CD8⁺, and CD19⁺ in the primary endpoint events were significantly different between the survival group and the death group (all P<0.05). The counts of CD3⁺, CD4⁺, CD8⁺, CD19⁺ in the secondary endpoint events were significantly different between the normal group and the severe/critical group (all P<0.05). The results of the receiver operating characteristic (ROC) curve showed that the area under the cellular immune function curve of dead patients and severe/critical patients had good predictive value (all P<0.05).Conclusion Cell immune function has good clinical and prognostic value for COVID-19.

Citation： CHEN You, LUO Yuchuan, WANG Kaijie, CAO Hui, LV Jianhong, ZHENG Jian, XU Yaqing. Clinical and prognostic value of cellular immune function in severe patients with coronavirus disease 2019 (COVID-19): A cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(6): 603-608. doi: 10.7507/1007-4848.202003133 Copy

1.	Xiang L, Zhou TJ, Zhou LL, et al. Influenza a virus and streptococcus pneumonia coinfection potentially promotes bacterial colonization and enhances B lymphocyte depression and reduction. J Biol Regul Homeost Agents, 2019, 33(5): 1437-1449.
2.	Zhang J, Deng R, Jia H, et al. Risk factors and peripheral blood lymphocyte subset analysis of patients with ventilator-associated pneumonia: a Chinese population-based study. Int J Clin Exp Pathol, 2019, 12(10): 3830-3838.
3.	李娜, 穆亚平, 陈静, 等. 淋巴细胞亚群绝对计数对儿童难治性肺炎支原体肺炎的早期预测作用. 中国当代儿科杂志, 2019, 21(6): 511-516.
4.	Graham RL, Donaldson EF, Baric RS. A decade after SARS: strategies for controlling emerging coronaviruses. Nat Rev Microbiol, 2013, 11(12): 836-848.
5.	Li G, Fan Y, Lai Y, et al. Coronavirus infections and immune responses. J Med Virol, 2020, 92(4): 424-432.
6.	Saghazadeh A, Rezaei N. Immune-epidemiological parameters of the novel coronavirus-a perspective. Expert Rev Clin Immunol, 2020, 6(4): 1-6.
7.	国家卫生健康委办公厅. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知. 中华人民共和国国家卫生健康委员会, 2020-03-03.
8.	中央赴湖北等疫情严重地区指导组. 关于进一步完善新型冠状病毒肺炎重型、危重型病例诊疗方案的通知. 中央指导组, 2020-03-03.
9.	Ali SB, Jeelall Y, Pennell CE, et al. The role of immunological testing and intervention in reproductive medicine: A fertile collaboration? Am J Repro Immunol, 2018, 79(3): 10.1111/aji.12784.
10.	李婕, 李怡, 冯瑞琳, 等. 昆明HIV感染吸毒者 CD4⁺ T淋巴细胞水平与CD4/CD8 比值调查分析. 国际病毒学杂志, 2019, 26(3): 157-160.
11.	李建国, 陈瑞, 魏菁. SARS患者急性期外周血CD3+、CD4+及CD8+细胞数量的变化. 免疫学杂志, 2004, 20(5): 382-384.
12.	张益明, 高世定, 王占科, 等. 3例新型冠状病毒肺炎患者外周血CD4+T淋巴细胞和CD4+/CD8+比值变化. 国际检验医学杂志, 2020. [Epub ahead of print].
13.	Zheng HY, Zhang M, Yang CX, et al. Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-19 patients. Cell Mol Immunol, 2020, 17(5): 541-543.
14.	卢子龙, 何如愿, 江文洋, 等. COVID-19患者临床特征及免疫功能分析. 武汉大学学报(医学版), 2020. [Epub ahead of print].
15.	Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest, 2020, 130(5): 2620-2629.
16.	Xiong Y, Liu Y, Cao L, et al. Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients. Emerg Microbes Infect, 2020, 9(1): 761-770.
17.	Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med, 2020, 8(4): 420-422.
18.	Shi SB, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol, 2020, e200950.
19.	Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020, 395(10223): 507-513.
20.	Burton DR. Antibodies, viruses and vaccines. Nat Rev Immunol, 2002, 2(9): 706-713.

1. Xiang L, Zhou TJ, Zhou LL, et al. Influenza a virus and streptococcus pneumonia coinfection potentially promotes bacterial colonization and enhances B lymphocyte depression and reduction. J Biol Regul Homeost Agents, 2019, 33(5): 1437-1449.
2. Zhang J, Deng R, Jia H, et al. Risk factors and peripheral blood lymphocyte subset analysis of patients with ventilator-associated pneumonia: a Chinese population-based study. Int J Clin Exp Pathol, 2019, 12(10): 3830-3838.
3. 李娜, 穆亚平, 陈静, 等. 淋巴细胞亚群绝对计数对儿童难治性肺炎支原体肺炎的早期预测作用. 中国当代儿科杂志, 2019, 21(6): 511-516.
4. Graham RL, Donaldson EF, Baric RS. A decade after SARS: strategies for controlling emerging coronaviruses. Nat Rev Microbiol, 2013, 11(12): 836-848.
5. Li G, Fan Y, Lai Y, et al. Coronavirus infections and immune responses. J Med Virol, 2020, 92(4): 424-432.
6. Saghazadeh A, Rezaei N. Immune-epidemiological parameters of the novel coronavirus-a perspective. Expert Rev Clin Immunol, 2020, 6(4): 1-6.
7. 国家卫生健康委办公厅. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知. 中华人民共和国国家卫生健康委员会, 2020-03-03.
8. 中央赴湖北等疫情严重地区指导组. 关于进一步完善新型冠状病毒肺炎重型、危重型病例诊疗方案的通知. 中央指导组, 2020-03-03.
9. Ali SB, Jeelall Y, Pennell CE, et al. The role of immunological testing and intervention in reproductive medicine: A fertile collaboration? Am J Repro Immunol, 2018, 79(3): 10.1111/aji.12784.
10. 李婕, 李怡, 冯瑞琳, 等. 昆明HIV感染吸毒者 CD4⁺ T淋巴细胞水平与CD4/CD8 比值调查分析. 国际病毒学杂志, 2019, 26(3): 157-160.
11. 李建国, 陈瑞, 魏菁. SARS患者急性期外周血CD3+、CD4+及CD8+细胞数量的变化. 免疫学杂志, 2004, 20(5): 382-384.
12. 张益明, 高世定, 王占科, 等. 3例新型冠状病毒肺炎患者外周血CD4+T淋巴细胞和CD4+/CD8+比值变化. 国际检验医学杂志, 2020. [Epub ahead of print].
13. Zheng HY, Zhang M, Yang CX, et al. Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-19 patients. Cell Mol Immunol, 2020, 17(5): 541-543.
14. 卢子龙, 何如愿, 江文洋, 等. COVID-19患者临床特征及免疫功能分析. 武汉大学学报(医学版), 2020. [Epub ahead of print].
15. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest, 2020, 130(5): 2620-2629.
16. Xiong Y, Liu Y, Cao L, et al. Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients. Emerg Microbes Infect, 2020, 9(1): 761-770.
17. Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med, 2020, 8(4): 420-422.
18. Shi SB, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol, 2020, e200950.
19. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020, 395(10223): 507-513.
20. Burton DR. Antibodies, viruses and vaccines. Nat Rev Immunol, 2002, 2(9): 706-713.

Next Article
先天性心脏病外科治疗中国专家共识（五）：再次开胸手术

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical and prognostic value of cellular immune function in severe patients with coronavirus disease 2019 (COVID-19): A cohort study

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content