Characteristics of peripheral lymphocyte subset alteration in COVID-19 pneumonia

10 avril 2020

Source : Journal of Infect Disease

Auteur : Fan Wang et al.


ANALYSE

Commentateur : Dr Caroline MAYEUR

Objectif :

  • etude des variations des sous populations lymphocytaires avant et après traitement

Principaux résultats :

  • 19 cas sévères, 41 modérés.
  • 72% ont une lymphopénie à l’admission par diminution globale des T B et NK, plus marquée chez les sévères.
  • Thérapeutique variée (corticoïdes, antiviraux, immunomodulateurs). Après une semaine de traitement, 37/60 sont répondeurs avec restauration de la lymphocytose (par restauration des T CD8+ surtout). Les non répondeurs restent lymphopéniques.
  • Les traitements immunomodulateurs ne semblent pas avoir d’effet “correcteur” de la déplétion lymphocytaire.

Points forts :

  • Point de suivi

 

Conclusion :

  • Confirme  la lymphopénie des patients SARSCoV2+, en particulier dans les formes sévères, par diminution globale des T B et NK.
  • Les patients répondeurs voient leur lymphocytose restaurée.

Retrouvez l’ensemble de l’analyse ICI

 

ABSTRACT

BACKGROUND.

Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19.

METHODS.

The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed.

RESULTS.

Total lymphocytes, CD4+ T cells, CD8+ T cells, B cells and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with the inflammatory status in COVID-19, especially CD8+ T cells and CD4+/CD8+ ratio. After treatment, 37 patients (67%) reached clinical response, with an increase of CD8+ T cells and B cells. No significant change of any subset was detected in non-response cases. In multivariate analysis, post-treatment decrease of CD8+ T cells and B cells and increase of CD4+/CD8+ ratio were indicated as independent predictors for poor efficacy.

Conclusions:

Peripheral lymphocyte subset alteration was associated with the clinical characteristics and treatment efficacy of COVID-19. CD8+ T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy

 

 


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