{"title":"外周血 T 淋巴细胞的动态变化对重症监护病房 COVID-19 患者的临床预后具有预测价值。","authors":"Dongling Wu, Xinmin Zhang, Yonah Ziemba, Nina Haghi, Judith Brody, Peihong Hsu","doi":"10.1177/2632010X211072818","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) patients with severe disease had a high mortality rate. It's imperative to identify risk factors associated with disease progression and prognosis. Immune responses played an important role in the host's defense against the virus. We studied the dynamics of peripheral blood lymphocytes (PBLs) in relation to the clinical outcome in COVID-19 patients in intensive care unit (ICU).</p><p><strong>Design: </strong>This cohort included 342 COVID-19 patients who were admitted to ICU between February 1 and May 30, 2020, with 178 having follow-up PBL analysis. The patients were divided into a group that survived and an expired group. PBL analysis was performed by flow cytometry.</p><p><strong>Results: </strong>At time of initial flow analysis, there were no statistically significant differences in lymphocyte, T-cell and subsets, B-cell or natural killer (NK) cell counts between the 2 groups. However, during the ICU course, the surviving group demonstrated a full recovery of CD3+ T-cells, CD4+ T-cells, and CD8+ T-cells, with no significant change in B-cells, and a slight upward trend in NK-cells. In contrast, the expired group showed no recovery in T-cells (and subsets) and no significant changes in B-cells and NK-cells. We identified the earliest time points and cut-off values for T-cell subsets that predict clinical outcomes.</p><p><strong>Conclusion: </strong>The results of this study suggest that evaluation of PBL in COVID-19 patients could be valuable in the study of the immune responses to the disease and the prognostication of outcome.</p>","PeriodicalId":53204,"journal":{"name":"Clinical Pathology","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/a9/10.1177_2632010X211072818.PMC8785304.pdf","citationCount":"0","resultStr":"{\"title\":\"Dynamics of Peripheral Blood T-lymphocytes Have Predictive Values for the Clinical Outcome of COVID-19 Patients in Intensive Care Unit.\",\"authors\":\"Dongling Wu, Xinmin Zhang, Yonah Ziemba, Nina Haghi, Judith Brody, Peihong Hsu\",\"doi\":\"10.1177/2632010X211072818\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) patients with severe disease had a high mortality rate. 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引用次数: 0
摘要
背景:2019年冠状病毒病(COVID-19)重症患者的死亡率很高。当务之急是确定与疾病进展和预后相关的风险因素。免疫反应在宿主抵御病毒的过程中发挥着重要作用。我们研究了重症监护室(ICU)中 COVID-19 患者外周血淋巴细胞(PBLs)的动态变化与临床结果的关系:该队列包括2020年2月1日至5月30日期间入住重症监护室的342名COVID-19患者,其中178人进行了随访PBL分析。患者分为存活组和死亡组。PBL分析通过流式细胞术进行:结果:在进行初始流式分析时,两组患者的淋巴细胞、T细胞和亚群、B细胞或自然杀伤(NK)细胞计数在统计学上没有显著差异。然而,在重症监护室治疗期间,存活组的 CD3+ T 细胞、CD4+ T 细胞和 CD8+ T 细胞完全恢复,B 细胞无明显变化,NK 细胞略有上升趋势。相比之下,过期组的 T 细胞(和亚群)没有恢复,B 细胞和 NK 细胞也没有明显变化。我们确定了可预测临床结果的最早时间点和 T 细胞亚群的临界值:本研究结果表明,评估 COVID-19 患者的 PBL 对研究该疾病的免疫反应和预后很有价值。
Dynamics of Peripheral Blood T-lymphocytes Have Predictive Values for the Clinical Outcome of COVID-19 Patients in Intensive Care Unit.
Background: Coronavirus disease 2019 (COVID-19) patients with severe disease had a high mortality rate. It's imperative to identify risk factors associated with disease progression and prognosis. Immune responses played an important role in the host's defense against the virus. We studied the dynamics of peripheral blood lymphocytes (PBLs) in relation to the clinical outcome in COVID-19 patients in intensive care unit (ICU).
Design: This cohort included 342 COVID-19 patients who were admitted to ICU between February 1 and May 30, 2020, with 178 having follow-up PBL analysis. The patients were divided into a group that survived and an expired group. PBL analysis was performed by flow cytometry.
Results: At time of initial flow analysis, there were no statistically significant differences in lymphocyte, T-cell and subsets, B-cell or natural killer (NK) cell counts between the 2 groups. However, during the ICU course, the surviving group demonstrated a full recovery of CD3+ T-cells, CD4+ T-cells, and CD8+ T-cells, with no significant change in B-cells, and a slight upward trend in NK-cells. In contrast, the expired group showed no recovery in T-cells (and subsets) and no significant changes in B-cells and NK-cells. We identified the earliest time points and cut-off values for T-cell subsets that predict clinical outcomes.
Conclusion: The results of this study suggest that evaluation of PBL in COVID-19 patients could be valuable in the study of the immune responses to the disease and the prognostication of outcome.