Analysis of the dynamic relationship between immune profiles and the clinical features of patients with COVID-19

BACKGROUND: The novel coronavirus disease (COVID-19) has been declared a global pandemic, with the cumulative number of confirmed cases and deaths exceeding 150 million and 3 million, respectively. Here, we examined the dynamic changes in the immune and clinical features of patients with COVID-19. METHODS: Clinical data of 98 patients with confirmed COVID-19 diagnosis were acquired from electronic medical records and curated. The data were analyzed based on the stage of the admission, deterioration, and convalescence, which included age, sex, severity, disease stages, biochemical indicators, immune cells, inflammatory cytokines, and immunoglobulins. Additionally, temporal changes in the immune response in patients undergoing continuous renal replacement therapy (CRRT) were also examined. RESULTS: Compared to mild stage patients, severe stage patients with COVID-19 exhibited a significant reduction in lymphocyte [23.10 (17.58–33.55) vs. 4.80 (2.95–6.50), P<0.001], monocyte [8.65 (7.28–10.00) vs. 3.45 (2.53–4.58), P<0.001], and NK cell levels [244.00 (150.50–335.00) vs. 59.00 (40.00–101.00), P<0.001] but showed elevated levels of neutrophils [64.90 (56.30–73.70) vs. 90.95 (87.60–93.68), P<0.001], inflammatory cytokines [Interleukin-10, 3.05 (1.37–3.86) vs. 5.94 (3.84–8.35), P=0.001; and tumor necrosis factor-α, 11.50 (6.55–26.45) vs. 12.96 (12.22–36.80), P=0.029], which improved during convalescence. Besides, the number of immune cells—T lymphocytes, B lymphocytes, helper T cells, suppressor T cells, NK cells, and monocytes, except neutrophils—slowly increased in critically ill patients receiving CRRT from 0 to 3 weeks. CONCLUSIONS: Our results indicate that the surveillance of immune cells may contribute to monitoring COVID-19 disease progression, and CRRT is a potential therapeutic strategy to regulate the immune balance in critically ill patients.