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Clinical indicators and immunological characteristics of COVID-19: a retrospective analysis of 123 cases
Journal of Army Medical University 2023, 45(7): 689-698
Published: 15 April 2023
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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.

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