Immunological and inflammatory profiles in mild and severe cases of COVID-19

COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19....

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Published inNature communications Vol. 11; no. 1; pp. 3410 - 10
Main Authors Song, Jin-Wen, Zhang, Chao, Fan, Xing, Meng, Fan-Ping, Xu, Zhe, Xia, Peng, Cao, Wen-Jing, Yang, Tao, Dai, Xiao-Peng, Wang, Si-Yu, Xu, Ruo-Nan, Jiang, Tian-Jun, Li, Wen-Gang, Zhang, Da-Wei, Zhao, Peng, Shi, Ming, Agrati, Chiara, Ippolito, Giuseppe, Maeurer, Markus, Zumla, Alimuddin, Wang, Fu-Sheng, Zhang, Ji-Yuan
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 08.07.2020
Nature Publishing Group
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Abstract COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients. Immunophenotyping of patients with COVID-19 is ongoing, but much remains to be learned. Here the authors analyze 41 hospitalized patients with COVID-19 and show a higher degree of lymphopenia in various immune cell subsets as well as cytotoxicity and T cell inhibitory marker expression in severe cases compared with mild.
AbstractList Immunophenotyping of patients with COVID-19 is ongoing, but much remains to be learned. Here the authors analyze 41 hospitalized patients with COVID-19 and show a higher degree of lymphopenia in various immune cell subsets as well as cytotoxicity and T cell inhibitory marker expression in severe cases compared with mild.
COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients.COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients.
COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients. Immunophenotyping of patients with COVID-19 is ongoing, but much remains to be learned. Here the authors analyze 41 hospitalized patients with COVID-19 and show a higher degree of lymphopenia in various immune cell subsets as well as cytotoxicity and T cell inhibitory marker expression in severe cases compared with mild.
COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients.Immunophenotyping of patients with COVID-19 is ongoing, but much remains to be learned. Here the authors analyze 41 hospitalized patients with COVID-19 and show a higher degree of lymphopenia in various immune cell subsets as well as cytotoxicity and T cell inhibitory marker expression in severe cases compared with mild.
COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients.
ArticleNumber 3410
Author Song, Jin-Wen
Meng, Fan-Ping
Wang, Si-Yu
Zhang, Da-Wei
Xu, Zhe
Wang, Fu-Sheng
Ippolito, Giuseppe
Yang, Tao
Fan, Xing
Xu, Ruo-Nan
Shi, Ming
Dai, Xiao-Peng
Zhang, Ji-Yuan
Jiang, Tian-Jun
Xia, Peng
Zumla, Alimuddin
Agrati, Chiara
Zhang, Chao
Cao, Wen-Jing
Li, Wen-Gang
Maeurer, Markus
Zhao, Peng
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  givenname: Jin-Wen
  orcidid: 0000-0002-8582-8012
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  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 2
  givenname: Chao
  surname: Zhang
  fullname: Zhang, Chao
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 3
  givenname: Xing
  orcidid: 0000-0002-0809-9207
  surname: Fan
  fullname: Fan, Xing
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 4
  givenname: Fan-Ping
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  fullname: Meng, Fan-Ping
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
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  givenname: Zhe
  surname: Xu
  fullname: Xu, Zhe
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 6
  givenname: Peng
  surname: Xia
  fullname: Xia, Peng
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 7
  givenname: Wen-Jing
  surname: Cao
  fullname: Cao, Wen-Jing
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Department of Clinical Medicine, Bengbu Medical College
– sequence: 8
  givenname: Tao
  surname: Yang
  fullname: Yang, Tao
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 9
  givenname: Xiao-Peng
  surname: Dai
  fullname: Dai, Xiao-Peng
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 10
  givenname: Si-Yu
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  fullname: Wang, Si-Yu
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 11
  givenname: Ruo-Nan
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  fullname: Xu, Ruo-Nan
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 12
  givenname: Tian-Jun
  surname: Jiang
  fullname: Jiang, Tian-Jun
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 13
  givenname: Wen-Gang
  surname: Li
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  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 14
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  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
– sequence: 15
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  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
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  fullname: Shi, Ming
  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
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  surname: Agrati
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  organization: National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS- Via Portuense
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  givenname: Giuseppe
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  surname: Ippolito
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  organization: National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS- Via Portuense
– sequence: 19
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– sequence: 20
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  organization: Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32641700$$D View this record in MEDLINE/PubMed
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Snippet COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been...
Immunophenotyping of patients with COVID-19 is ongoing, but much remains to be learned. Here the authors analyze 41 hospitalized patients with COVID-19 and...
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Aged, 80 and over
Betacoronavirus - immunology
Betacoronavirus - pathogenicity
Biomarkers - metabolism
CD4 antigen
CD4-Positive T-Lymphocytes - immunology
CD4-Positive T-Lymphocytes - pathology
CD8 antigen
CD8-Positive T-Lymphocytes - immunology
CD8-Positive T-Lymphocytes - pathology
Cell activation
Chemotaxis, Leukocyte
China - epidemiology
Coronavirus Infections - blood
Coronavirus Infections - immunology
Coronavirus Infections - pathology
Coronavirus Infections - virology
Coronaviruses
COVID-19
Cytokines - blood
Cytotoxicity
Epidemiology
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Humanities and Social Sciences
Humans
Immune system
Immunology
Inflammation
Killer Cells, Natural - immunology
Killer Cells, Natural - pathology
Leukocyte Count
Lung - immunology
Lung - virology
Lymphocyte Activation
Lymphocytes
Lymphocytes T
Lymphopenia
Macrophages
Male
Middle Aged
multidisciplinary
Pandemics
Pathogenesis
Patients
Pneumonia, Viral - blood
Pneumonia, Viral - immunology
Pneumonia, Viral - pathology
Pneumonia, Viral - virology
Ribonucleic acid
RNA
SARS-CoV-2
Science
Science (multidisciplinary)
Severe acute respiratory syndrome coronavirus 2
Therapeutic applications
Toxicity
Viral diseases
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Title Immunological and inflammatory profiles in mild and severe cases of COVID-19
URI https://link.springer.com/article/10.1038/s41467-020-17240-2
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