COVID-19を有する成人患者における末梢血リンパ球サブセットの動的変化

Dynamic changes of peripheral blood lymphocytes subsets in adult patients with COVID-19.

• Zhifeng Deng
• Minli Zhang
• Ting Zhu
• Zhili Liu
• Zheming Liu
• Rong Xiang
• Wei Zhang
• Yu Xu

抄録

はじめに:

重症急性呼吸器症候群コロナウイルス2（SARS-CoV-2）感染によるコロナウイルス疾患2019（COVID-19）が広く流行している。COVID-19の成人患者における末梢血リンパ球サブセットの動態変化を調べることを目的としています。

INTRODUCTION: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been widely spread. We aim to investigate the dynamic changes of peripheral blood lymphocytes subsets in adult patients with COVID-19.

方法:

SARS-CoV-2 ウイルス感染が確認された COVID-19 入院患者 435 例の人口統計学、臨床症状、併存疾患、検査データ、放射線資料を含む電子カルテを抽出し、レトロスペクティブに解析した。発症後の各週のリンパ球サブセット数を他の週と健常者と比較した。

METHODS: Electronic medical records including demographics, clinical manifestation, comorbidities, laboratory data, and radiological materials of 435 hospitalized COVID-19 patients, with confirmed result of SARS-CoV-2 viral infection, were extracted and retrospectively analyzed. The counts of lymphocyte subsets at each week after the onset of the illness were compared with other weeks of illness and with those from normal individuals.

結果:

各種リンパ球サブセット（CD3+、CD4+、CD8+、CD19+、CD16/56+）は、発症後1週目に正常範囲を下回り、2週目に直下型に達し、3週目には徐々に増加し、5週目には正常値に戻ったが、健常対照者よりは低い値であった。CD3+、CD4+およびCD8+数は、重症患者では非重症患者に比べて有意に減少し、死亡した患者では回復した患者に比べて有意に減少した。

RESULTS: The various lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD19 +and CD16/56 +) were below the normal ranges at the first week after the onset of the illness, reaching a nadir during the second week, which increased gradually in the third week and returned to normal levels in the fifth week, but was still lower than the healthy controls. The CD3+, CD4+ and CD8+ counts were significantly lower in those with severe disease compared to those with non-severe disease, and in those patients that died compared to those who recovered.

DISCUSSION:

我々の研究は、COVID-19患者における末梢血リンパ球サブセット（CD3 +、CD4 +、およびCD8 +）のレベルが、疾患の進行、重症度、および予後と関連していることを示している。ヒト免疫機能の動的モニタリングは、COVID-19患者の重症度と予後を評価する指標の一つであり、適切な治療戦略の策定に役立つ。

DISCUSSION: our research indicates that the levels of peripheral blood lymphocyte subsets (CD3 +, CD4 +, and CD8 +) are associated with disease progression, severity, and prognosis in patients with COVID-19. Dynamic monitoring of human immune function is one of the indicators for evaluating the severity and prognosis of COVID-19 patients, and it is helpful to formulate appropriate treatment strategies.

Copyright © 2020. Published by Elsevier Ltd.