Journal Article

Immunological and inflammatory profiles in mild and severe cases of COVID-19

Song, Jin-Wen, Meng, Fan-Ping, Wang, Si-Yu, Zhang, Da-Wei, Xu, Zhe, Wang, Fu-Sheng, Ippolito, Giuseppe, Yang, Tao, Fan, Xing, Xu, Ruo-Nan, Shi, Ming, Dai, Xiao-Peng, Zhang, Ji-Yuan, Jiang, Tian-Jun, Xia, Peng, Zumla, Alimuddin, Agrati, Chiara, Zhang, Chao, Cao, Wen-Jing, Li, Wen-Gang, Maeurer, Markus, Zhao, Peng

2020

Overview

COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients. Immunophenotyping of patients with COVID-19 is ongoing, but much remains to be learned. Here the authors analyze 41 hospitalized patients with COVID-19 and show a higher degree of lymphopenia in various immune cell subsets as well as cytotoxicity and T cell inhibitory marker expression in severe cases compared with mild.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 13/1 / 13/21 / 13/31 / 13/51 / 631/250/254 / 631/250/255/2514 / 631/250/256/2516 / Adult / Aged / Aged, 80 and over / Betacoronavirus - immunology / Betacoronavirus - pathogenicity / Biomarkers - metabolism / CD4 antigen / CD4-Positive T-Lymphocytes - immunology / CD4-Positive T-Lymphocytes - pathology / CD8 antigen / CD8-Positive T-Lymphocytes - immunology / CD8-Positive T-Lymphocytes - pathology / Cell activation / Chemotaxis, Leukocyte / China - epidemiology / Coronavirus Infections - blood / Coronavirus Infections - immunology / Coronavirus Infections - pathology / Coronavirus Infections - virology / Coronaviruses / COVID-19 / Cytokines - blood / Cytotoxicity / Epidemiology / Female / Humanities and Social Sciences / Humans / Immune system / Immunology / Inflammation / Killer Cells, Natural - immunology / Killer Cells, Natural - pathology / Leukocyte Count / Lung - immunology / Lung - virology / Lymphocyte Activation / Lymphocytes / Lymphocytes T / Lymphopenia / Macrophages / Male / Middle Aged / multidisciplinary / Pandemics / Pathogenesis / Patients / Pneumonia, Viral - blood / Pneumonia, Viral - immunology / Pneumonia, Viral - pathology / Pneumonia, Viral - virology / Ribonucleic acid / RNA / SARS-CoV-2 / Science / Science (multidisciplinary) / Severe acute respiratory syndrome coronavirus 2 / Therapeutic applications / Toxicity / Viral diseases