Cargando…
Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients
CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier: NCT04365634. CONTEXT: Diabetes mellitus was associated with increased severity and mortality of disease in COVID-19 pneumonia. So far the effect of type 2 diabetes (T2DM) or hyperglycemia on the immune system among COVID-19 disease has...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992040/ https://www.ncbi.nlm.nih.gov/pubmed/33776910 http://dx.doi.org/10.3389/fendo.2021.596518 |
_version_ | 1783669295497084928 |
---|---|
author | Han, Meifang Ma, Ke Wang, Xiaojing Yan, Weiming Wang, Hongwu You, Jie Wang, Qiuxia Chen, Huilong Guo, Wei Chen, Tao Ning, Qin Luo, Xiaoping |
author_facet | Han, Meifang Ma, Ke Wang, Xiaojing Yan, Weiming Wang, Hongwu You, Jie Wang, Qiuxia Chen, Huilong Guo, Wei Chen, Tao Ning, Qin Luo, Xiaoping |
author_sort | Han, Meifang |
collection | PubMed |
description | CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier: NCT04365634. CONTEXT: Diabetes mellitus was associated with increased severity and mortality of disease in COVID-19 pneumonia. So far the effect of type 2 diabetes (T2DM) or hyperglycemia on the immune system among COVID-19 disease has remained unclear. OBJECTIVE: We aim to explore the clinical and immunological features of type 2 diabetes mellitus (T2DM) among COVID-19 patients. DESIGN AND METHODS: In this retrospective study, the clinical and immunological characteristics of 306 hospitalized confirmed COVID-19 patients (including 129 diabetic and 177 non-diabetic patients) were analyzed. The serum concentrations of laboratory parameters including cytokines and numbers of immune cells were measured and compared between diabetic and non-diabetic groups. RESULTS: Compared with non-diabetic group, diabetic cases more frequently had lymphopenia and hyperglycemia, with higher levels of urea nitrogen, myoglobin, D-dimer and ferritin. Diabetic cases indicated the obviously elevated mortality and the higher levels of cytokines IL‐2R, IL‐6, IL‐8, IL‐10, and TNF‐α, as well as the distinctly reduced Th1/Th2 cytokines ratios compared with non-diabetic cases. The longitudinal assays showed that compared to that at week 1, the levels of IL-6 and IL-8 were significantly elevated at week 2 after admission in non-survivors of diabetic cases, whereas there were greatly reductions from week 1 to week 2 in survivors of diabetic cases. Compared with survival diabetic patients, non-survival diabetic cases displayed distinct higher serum concentrations of IL-2R, IL-6, IL-8, IL-10, TNF‐α, and lower Th1/Th2 cytokines ratios at week 2. Samples from a subset of participants were evaluated by flow cytometry for the immune cells. The counts of peripheral total T lymphocytes, CD4(+) T cells, CD8(+) T cells and NK cells were markedly lower in diabetic cases than in non-diabetic cases. The non-survivors showed the markedly declined counts of CD8(+) T cells and NK cells than survivors. CONCLUSION: The elevated cytokines, imbalance of Th1/Th2 cytokines ratios and reduced of peripheral numbers of CD8(+) T cells and NK cells might contribute to the pathogenic mechanisms of high mortality of COVID-19 patients with T2DM. |
format | Online Article Text |
id | pubmed-7992040 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79920402021-03-26 Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients Han, Meifang Ma, Ke Wang, Xiaojing Yan, Weiming Wang, Hongwu You, Jie Wang, Qiuxia Chen, Huilong Guo, Wei Chen, Tao Ning, Qin Luo, Xiaoping Front Endocrinol (Lausanne) Endocrinology CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier: NCT04365634. CONTEXT: Diabetes mellitus was associated with increased severity and mortality of disease in COVID-19 pneumonia. So far the effect of type 2 diabetes (T2DM) or hyperglycemia on the immune system among COVID-19 disease has remained unclear. OBJECTIVE: We aim to explore the clinical and immunological features of type 2 diabetes mellitus (T2DM) among COVID-19 patients. DESIGN AND METHODS: In this retrospective study, the clinical and immunological characteristics of 306 hospitalized confirmed COVID-19 patients (including 129 diabetic and 177 non-diabetic patients) were analyzed. The serum concentrations of laboratory parameters including cytokines and numbers of immune cells were measured and compared between diabetic and non-diabetic groups. RESULTS: Compared with non-diabetic group, diabetic cases more frequently had lymphopenia and hyperglycemia, with higher levels of urea nitrogen, myoglobin, D-dimer and ferritin. Diabetic cases indicated the obviously elevated mortality and the higher levels of cytokines IL‐2R, IL‐6, IL‐8, IL‐10, and TNF‐α, as well as the distinctly reduced Th1/Th2 cytokines ratios compared with non-diabetic cases. The longitudinal assays showed that compared to that at week 1, the levels of IL-6 and IL-8 were significantly elevated at week 2 after admission in non-survivors of diabetic cases, whereas there were greatly reductions from week 1 to week 2 in survivors of diabetic cases. Compared with survival diabetic patients, non-survival diabetic cases displayed distinct higher serum concentrations of IL-2R, IL-6, IL-8, IL-10, TNF‐α, and lower Th1/Th2 cytokines ratios at week 2. Samples from a subset of participants were evaluated by flow cytometry for the immune cells. The counts of peripheral total T lymphocytes, CD4(+) T cells, CD8(+) T cells and NK cells were markedly lower in diabetic cases than in non-diabetic cases. The non-survivors showed the markedly declined counts of CD8(+) T cells and NK cells than survivors. CONCLUSION: The elevated cytokines, imbalance of Th1/Th2 cytokines ratios and reduced of peripheral numbers of CD8(+) T cells and NK cells might contribute to the pathogenic mechanisms of high mortality of COVID-19 patients with T2DM. Frontiers Media S.A. 2021-03-11 /pmc/articles/PMC7992040/ /pubmed/33776910 http://dx.doi.org/10.3389/fendo.2021.596518 Text en Copyright © 2021 Han, Ma, Wang, Yan, Wang, You, Wang, Chen, Guo, Chen, Ning and Luo http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Han, Meifang Ma, Ke Wang, Xiaojing Yan, Weiming Wang, Hongwu You, Jie Wang, Qiuxia Chen, Huilong Guo, Wei Chen, Tao Ning, Qin Luo, Xiaoping Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients |
title | Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients |
title_full | Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients |
title_fullStr | Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients |
title_full_unstemmed | Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients |
title_short | Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients |
title_sort | immunological characteristics in type 2 diabetes mellitus among covid-19 patients |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992040/ https://www.ncbi.nlm.nih.gov/pubmed/33776910 http://dx.doi.org/10.3389/fendo.2021.596518 |
work_keys_str_mv | AT hanmeifang immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT make immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT wangxiaojing immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT yanweiming immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT wanghongwu immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT youjie immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT wangqiuxia immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT chenhuilong immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT guowei immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT chentao immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT ningqin immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients AT luoxiaoping immunologicalcharacteristicsintype2diabetesmellitusamongcovid19patients |