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

• Published in: Nature 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
• Language: English
• Published: London Nature Publishing Group UK 08.07.2020; Nature Publishing Group; Nature Portfolio
• Subjects: 13/1; 13/21; 13/31; 13/51; 631/250/254; 631/250/255/2514; 631/250/256/2516; Adult; Aged; 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; Female; 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; China
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-020-17240-2

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.