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Publications

Journal Article Epublish

PubMed: 39595989 DOI: 10.3390/ijms252211921

Dynamic Changes in Lymphocyte Populations and Their Relationship with Disease Severity and Outcome in COVID-19.

Int J Mol Sci 25(22)

Authors: Ákos Vince Andrejkovits, Adina Huțanu, Doina Ramona Manu, Minodora Dobreanu, Anca Meda Văsieșiu

Affiliations

  • Department of Infectious Disease, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania.
  • Doctoral School of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania.
  • Department of Laboratory Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania.
  • Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania.
  • 1st Infectious Disease Clinic of County Clinical Hospital, 540146 Târgu Mureș, Romania.

Abstract

Studies suggest that the dynamic changes in cellular response might correlate with disease severity and outcomes in SARS-CoV-2 patients. The study aimed to investigate the dynamic changes of lymphocyte subsets in patients with COVID-19. In this regard, 53 patients with COVID-19 were prospectively included, classified as mild, moderate, and severe. The peripheral lymphocyte profiles (LyT, LyB, and NK cells), as well as CD4+/CD8+, CD3+/CD19+, CD3+/NK and CD19+/NK ratios, and their dynamic changes during hospitalization and correlation with disease severity and outcome were assessed. We found significant differences in CD3+ lymphocytes between severity groups ( < 0.0001), with significantly decreased CD3+CD4+ and CD3+CD8+ in patients with severe disease ( < 0.0001 and = 0.048, respectively). Lower CD3+/CD19+ and CD3+/NK ratios among patients with severe disease ( = 0.019 and = 0.010, respectively) were found. The dynamic changes of lymphocyte subsets showed a significant reduction in NK cells (%) and a significant increase in CD3+CD4+ and CD3+CD8+ cells in patients with moderate and severe disease. The ROC analysis on the relationship between CD3+ cells and fatal outcome yielded an AUC of 0.723 (95% CI 0.583-0.837; = 0.007), while after addition of age and SpO, ferritin and NLR, the AUC significantly improved to 0.927 (95%CI 0.811-0.983), < 0.001 with a sensitivity of 90.9% (95% CI 58.7-99.8%) and specificity of 85.7% (95% CI 69.7-95.2%). The absolute number of CD3+ lymphocytes might independently predict fatal outcomes in COVID-19 patients and T-lymphocyte subset evaluation in high-risk patients might be useful in estimating disease progression.

MeSH

Cells, Lymphocytes, Fatal Outcome, Covid-19, Lymphocyte Subsets