Changes of peripheral lymphocyte subset in patients with SARS-CoV-2 infection during the whole course of disease

ABSTRACT

Background: Little is known about changes in lymphocyte subsets after SARS-CoV-2 infection.

Methods: Clinical data of 580 COVID-19 patients hospitalized in Zhongnan Hospital of Wuhan University from 20 December 2019, to 8 March 2020, were retrospectively analyzed. The relation of lymphocyte subsets and severity or prognosis of disease were analyzed.

Results: At 2–3 weeks after the onset of symptoms, lymphocyte subsets decreased to the lowest levels. The levels of lymphocyte subsets in asymptomatic patients were close to healthy persons, except for CD8⁺ T lymphocyte cells. The levels of lymphocyte subsets in patients with severe illness were lower than that in patients with mild-to-moderate illness (P < 0.01). Similarly, among patients with severe illness, lower levels of lymphocyte subsets were found in dead patients compared to survivors (P < 0.001). Moreover, by comparing the results of the same patients at different stages of the disease, we found levels of lymphocyte subsets were lower in the acute phase compared to that in convalescent-phase (P < 0.001). However, the levels of lymphocyte subsets in patients who had SARS-CoV-2 viral load >5000 copies/ml and 500–5000 copies/ml were at similar levels.

Conclusions: Lymphocyte subsets are a good biomarker to assess the severity and prognosis of the disease at 2–3 weeks after the onset of symptoms.

KEYWORDS:

• Lymphocyte subsets
• sars-CoV-2
• immune response
• covid-19

Article highlights

• At 2–3 weeks after the onset of symptoms, CD4⁺ T lymphocyte cells, CD8⁺ T lymphocyte cells, CD19⁺ B cells, and CD16⁺CD56⁺ NK cells decreased to the lowest levels.

• The levels of lymphocyte subsets in asymptomatic patients with SARS-CoV-2 infection were close to healthy persons, except for the CD8⁺ T lymphocyte cells.

• Levels of lymphocyte subsets are found associated with the severity and prognosis of the disease in patients with SARS-CoV-2 infection.

• No, correlation was found between SARS-CoV-2 viral load and lymphocyte subsets, which suggesting that decreased lymphocyte subset levels in COVID-19 patients was not directly caused by SARS-CoV-2 itself.

• The levels of lymphocyte subsets in COVID-19 patients in convalescent-phase increased along with the improvement of lung symptoms.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors’ contributions

Rongrong Yang and Xingxia Yu drafted and supervised the manuscript. All authors were responsible for summarizing all data related to this study.

Additional information

Funding

This project was supported by the National Natural Science Foundation of China (Grant No. 82003511).