Immune Characteristics of Patients with Coronavirus Disease 2019 (COVID-19)

doi:10.14336/AD.2020.0317

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Abstract

Up to now, little is known about the detailed immune profiles of COVID-19 patients from admission to discharge. In this study we retrospectively reviewed the clinical and laboratory characteristics of 18 COVID-19 patients from January 30, 2020 to February 21, 2020. These patients were divided into two groups; group 1 had a severe acute respiratory syndrome coronavirus 2 nucleic acid-positive duration for more than 15 days (n = 6) and group 2 had a nucleic acid-positive duration for less than 15 days (n = 12). Group 1 patients had lower level of peripheral blood lymphocytes (0.40 vs. 0.78 ×10⁹/L, p = 0.024) and serum potassium (3.36 vs. 3.79 mmol/L, p = 0.043) on admission but longer hospitalization days (23.17 vs. 15.75 days, p < 0.001) compared to Group 2 patients. Moreover, baseline level of lymphocytes (r = -0.62, p = 0.006) was negatively correlated with the nucleic acid-positive duration. Additionally, lymphocytes (420.83 vs. 1100.56 /μL), T cells (232.50 vs. 706.78 /μL), CD4⁺ T cells (114.67 vs. 410.44 /μL), and CD8⁺ T cells (94.83 vs. 257.44 /μL) in the peripheral blood analyzed by flow cytometry were significantly different between Group 1and Group 2. Furthermore, there was also a negative correlation between lymphocytes (r = -0.54, p = 0.038) or T cells (r = -0.55, p = 0.034) at diagnosis and the nucleic acid-positive duration, separately. In conclusion, the patients with nucleic acid-positive ≥ 15 days had significantly decreased lymphocytes, T cell and its subsets compared to those who remained positive for less than 15 days.

Keywords coronavirus disease 2019 (COVID-19) immune characteristics lymphocyte subsets serum potassium

Corresponding Authors: Cao Hongcui

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These authors contributed equally to this work.

Just Accepted Date: 19 March 2020 Online First Date: 20 March 2020 Issue Date: 13 May 2020

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	Dong Xiaotian
	Wang Mengyan
	Liu Shuangchun
	Zhu Jiaqi
	Xu Yanping
	Cao Hongcui
	Li Lanjuan

Cite this article:

Dong Xiaotian,Wang Mengyan,Liu Shuangchun, et al. Immune Characteristics of Patients with Coronavirus Disease 2019 (COVID-19)[J]. Aging and disease, 2020, 11(3): 642-648.

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http://www.aginganddisease.org/EN/10.14336/AD.2020.0317 OR

Characteristics	COVID-19 patients (n = 18)	Nucleic acid-positive <15 days (n = 12)	Nucleic acid-positive≥15 days (n = 6)	p value¹
Age (years)	58.39 ± 17.21	56.50 ± 16.54	62.17 ± 19.47	0.527
Male, no. (%)	11 (61.11)	7 (58.33)	4 (66.67)	1.000
Hospitalization days	18.22 ± 4.86	15.75 ± 3.55	23.17 ± 2.93	<0.001*
SARS-CoV-2 nucleic acid-positive duration (day)	11.89 ± 7.28	7.50 ± 3.40	20.67 ± 4.03	<0.001*
Laboratory data
Activated partial thromboplastin time (sec)	31.55 ± 6.04	30.68 ± 3.34	33.30 ± 9.70	0.401
International normalized ratio	0.99 ± 0.10	0.97 ± 0.06	1.05 ± 0.15	0.130
Prothrombin time (sec)	11.92 ± 1.20	11.62 ± 0.72	12.53 ± 1.76	0.130
D-dimer (μg/L)	877.56 ± 983.70	948.25 ± 1090.61	798.34 ± 325.92	0.680
White blood cell (10⁹/L)	9.17 ± 5.24	9.29 ± 5.21	8.93 ± 5.80	0.896
Neutrophils (10⁹/L)	8.16 ± 5.14	8.08 ± 5.21	8.30 ± 5.48	0.936
Lymphocytes (10⁹/L)	0.66 ± 0.46	0.78 ± 0.49	0.40 ± 0.27	0.024*
Hemoglobin (g/L)	131.17 ± 16.38	134.33 ± 15.95	124.83 ± 16.73	0.258
Monocytes (10⁹/L)	0.33 ± 0.23	0.39 ± 0.25	0.22 ± 0.10	0.144
Procalcitonin (ng/mL)	0.09 ± 0.09	0.09 ± 0.09	0.10 ± 0.09	0.899
Lactate dehydrogenase (U/L)	317.78 ± 136.18	305.42 ± 76.46	342.50 ± 221.57	0.601
Total bilirubin (μmol/L)	13.16 ± 7.56	11.94 ± 7.52	15.58 ± 7.70	0.351
Alanine aminotransferase (U/L)	25.22 ± 13.52	27.00 ± 13.71	21.67 ± 13.60	0.447
Albumin (g/L)	37.61 ± 5.00	38.55 ± 5.66	35.72 ± 2.82	0.269
Glutamyl transpeptidase (U/L)	45.78 ± 32.43	43.58 ± 24.99	50.17 ± 46.55	0.697
Alkaline phosphatase (U/L)	76.00 ± 31.60	81.42 ± 34.48	65.17 ± 23.86	0.318
Creatinine (μmol/L)	86.83 ± 67.25	94.08 ± 81.24	72.33 ± 21.91	0.534
Aspartate aminotransferase (U/L)	26.56 ± 14.02	26.17 ± 10.05	27.33 ± 21.09	0.874
C reactive protein (mg/L)	36.70 ± 44.02	28.68 ± 38.61	52.74 ± 53.33	0.288
Blood lactic acid (mmol/L)	2.13 ± 0.94	2.14 ± 1.16	2.10 ± 0.30	0.933
Partial pressure of oxygen (mmHg)	96.55 ± 47.30	108.66 ± 50.37	72.33 ± 31.14	0.128
Oxygen saturation (%)	94.35 ± 7.07	96.51 ± 2.73	90.03 ± 10.95	0.210
Hematocrit (%)	41.76 ± 7.57	42.02 ± 6.90	41.25 ± 9.48	0.847
Potassium (mmol/L)	3.65 ± 0.44	3.79 ± 0.33	3.36 ± 0.52	0.043*
Sodium (mmol/L)	138.11 ± 10.44	139.75 ± 3.79	134.83 ± 17.87	0.533
Creatine kinase (U/L)	22.33 ± 7.68	22.25 ± 8.57	22.50 ± 6.22	0.950

Table 1 Characteristics of COVID-19 patients on admission.

Figure 1. Correlation analysis between lymphocytes count and the duration of nucleic acid-positive of COVID-19 patients. Lymphocytes count in peripheral blood (A) but not serum potassium level (B) at admission was negatively correlated with the SARS-CoV-2 nucleic acid-positive duration. Spearman correlation analysis was performed. p<0.05 as statistical significance.

Table 2 Characteristics of serum cytokines of COVID-19 patients at diagnosis.

Table 3 Lymphocyte subsets in COVID-19 patients at diagnosis and at discharge.

Figure 2. Correlation analysis between lymphocyte subset numbers and the nucleic acid-positive duration of COVID-19 patients. Lymphocytes count in peripheral blood (A) and T cells (B) at diagnosis were negatively correlated with the duration of SARS-CoV-2 nucleic acid-positive. CD4⁺ T cells (C) and CD8⁺ T cells (D) were not correlated with the duration of SARS-CoV-2 nucleic acid-positive. Spearman correlation analysis was performed. p<0.05 as statistical significance.

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[1]	Hong Liu, Shiyan Chen, Min Liu, Hao Nie, Hongyun Lu. Comorbid Chronic Diseases are Strongly Correlated with Disease Severity among COVID-19 Patients: A Systematic Review and Meta-Analysis[J]. Aging and disease, 2020, 11(3): 668-678.

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