ABSTRACT
Millions of people infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been diagnosed with coronavirus infectious disease 2019 (COVID-19). The prevalence and severity of COVID-19 differ between sexes. To explain these differences, we analyzed clinical features and laboratory values in male and female COVID-19 patients. The present study included a cohort of 111 people, i.e. 36 COVID-19 patients, 54 sex- and age-matched common viral community-acquired pneumonia (CAP) patients, and 21 healthy controls. Monocyte counts, lymphocyte subset counts, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), and C-reactive protein (CRP) levels in the peripheral blood were analyzed. Higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, monocyte counts, and CRP and ALT levels were found in male COVID-19 patients. Decreased lymphocyte subset counts and proportions were observed in COVID-19 patients, except for the CD3+ and CD8+ T cell proportions. The lower CD4+ T cell proportions and higher CD8+ T cell proportions were observed in male and severe COVID-19 patients and the differences were independent of estrogen level. The CD4+ T cell proportion was negatively associated with the CD8+ T cell proportion in male COVID-19 patients; this correlation was non-significant in females. Our work demonstrates differences between sexes in circulating monocyte counts and CD4+ T cell and CD8+ T cell proportions in COVID-19 patients, independent of estrogen levels, are associated with the clinical manifestations in COVID-19 patients with high specificity.
Subject(s)
COVID-19/immunology , Immunity, Innate , Lymphocytes/virology , Monocytes/virology , Pneumonia, Viral/immunology , SARS-CoV-2/pathogenicity , Adult , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , C-Reactive Protein/metabolism , CD4-CD8 Ratio , COVID-19/pathology , COVID-19/virology , Case-Control Studies , Community-Acquired Infections , Estradiol/blood , Female , Humans , Leukocyte Count , Lymphocytes/immunology , Male , Middle Aged , Monocytes/immunology , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , Severity of Illness Index , Sex FactorsABSTRACT
BACKGROUND: Clinical recovery does not mean full recovery. It is necessary to explore the aftereffects of COVID-19 in patients and compare the laboratory features of COVID-19 and other viral pneumonias in the recovery stages. METHODS: Forty-seven cases of COVID-19 and 45 cases of other viral pneumonias (control) were included in this study. The laboratory parameters were compared between COVID-19 and control patients as well as severe and moderate COVID-19 patients from the clinical recovery stage to the 4 weeks postdischarge recovery stage. RESULTS: A higher RDW-CV level and neutrophil percentage and lower levels of total proteins, lymphocytes, eosinophils, and MCH were found in COVID-19 patients compared with those in controls from the clinical recovery to the postdischarge recovery stages. Further analysis showed that decreases in lymphocytes, total proteins, and SOD and elevations in neutrophils, FDP, CRP, and ESR were more common in severe than moderate cases of COVID-19 during hospitalization; however, differences in these indicators, except total proteins, were not observed in the postdischarge recovery stages. Additionally, only 76.9% of COVID-19 patients were positive for IgG antibodies against SARS-CoV-2 in the convalescence stage, and one patient that was negative for specific IgG was reinfected. CONCLUSIONS: This study demonstrated that patients recovering from COVID-19 might need better care than that patients with other viral pneumonias due to the possibility of having poor immunity and nutritional conditions. These findings provide new insights to improve the understanding of COVID-19 and improve care for patients affected by these kinds of pandemics in the future.