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Early Phases of COVID-19 Are Characterized by a Reduction in Lymphocyte Populations and the Presence of Atypical Monocytes

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 is a recently discovered pathogen responsible of coronavirus disease 2019 (COVID-19). The immunological changes associated with this infection are largely unknown. METHODS: We evaluated the peripheral blood mononuclear cells profile of 63 p...

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Detalles Bibliográficos
Autores principales: Lombardi, Andrea, Trombetta, Elena, Cattaneo, Alessandra, Castelli, Valeria, Palomba, Emanuele, Tirone, Mario, Mangioni, Davide, Lamorte, Giuseppe, Manunta, Maria, Prati, Daniele, Ceriotti, Ferruccio, Gualtierotti, Roberta, Costantino, Giorgio, Aliberti, Stefano, Scaravilli, Vittorio, Grasselli, Giacomo, Gori, Andrea, Porretti, Laura, Bandera, Alessandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756112/
https://www.ncbi.nlm.nih.gov/pubmed/33362757
http://dx.doi.org/10.3389/fimmu.2020.560330
Descripción
Sumario:BACKGROUND: Severe acute respiratory syndrome coronavirus 2 is a recently discovered pathogen responsible of coronavirus disease 2019 (COVID-19). The immunological changes associated with this infection are largely unknown. METHODS: We evaluated the peripheral blood mononuclear cells profile of 63 patients with COVID-19 at diagnosis. We also assessed the presence of association with inflammatory biomarkers and the 28-day mortality. RESULTS: Lymphocytopenia was present in 51 of 63 (80.9%) patients, with a median value of 720 lymphocytes/µl (IQR 520-1,135). This reduction was mirrored also on CD8+ (128 cells/µl, IQR 55-215), natural killer (67 cells/µl, IQR 35–158) and natural killer T (31 cells/µl, IQR 11–78) cells. Monocytes were preserved in total number but displayed among them a subpopulation with a higher forward and side scatter properties, composed mainly of cells with a reduced expression of both CD14 and HLA-DR. Patients who died in the 28 days from admission (N=10, 15.9%), when compared to those who did not, displayed lower mean values of CD3+ (337.4 cells/µl vs 585.9 cells/µl; p=0.028) and CD4+ cells (232.2 cells/µl vs 381.1 cells/µl; p=0.042) and an higher percentage of CD8+/CD38+/HLA-DR+ lymphocytes (13.5% vs 7.6%; p=0.026). DISCUSSION: The early phases of COVID-19 are characterized by lymphocytopenia, predominance of Th2-like lymphocytes and monocytes with altered immune profile, which include atypical mononuclear cells.