Editorial Office of Journal of Army Medical University
Doi
Abstract
Objective To study the relevant clinical indicators and immunological characteristics of patients with different levels of Corona Virus Disease 2019 (COVID-19). Methods A total of 123 patients with confirmed COVID-19 admitted to Wuhan Huoshenshan Hospital from February 5 to April 10, 2020 were enrolled as the study objects. According to Novel Coronavirus Pneumonia Treatment Protocol (6th Edition), they were divided into recovery (n=69), severe (n=45), and death (n=9) groups. Their electronic medical records were collected, and basic data, clinical symptoms, and results of laboratory examinations were analyzed statistically. A cross-sectional study was conducted on the expression levels of serum cytokines, T cell characteristics, and PD-1 expression on T cells. All data were analyzed using GraphPad Prism 8.0 software. Results There were 74 male and 49 female COVID-19 patients, with a median age of 63.94 years in this study, and among them, 79 were over 60 years old. Plasma C-reactive protein (CRP), lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBHD), cystatin C (CysC), and procalcitonin (PCT) were significantly elevated in the severe disease and death groups (P < 0.05). The 2 groups also had obviously higher serum levels of IL-2, IL-6, IL-8, IL-10 and IL-17 than the recovery group (P < 0.05). The patients from the death group had the lowest peripheral blood lymphocyte count and the highest neutrophil count (P < 0.05). The expression level of PD-1 in CD4+ T cells and CD8+ T cells was notably higher in the severe and death groups than the recovery group (P < 0.05). Conclusion Age is associated with the level of COVID-19. And the levels of cytokines such as IL-6 and IL-8, decrease of T lymphocytes and exhaustion of T cell function are closely correlated with the severity of COVID-19