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Dynamic SARS-CoV-2-Specific Immunity in Critically Ill Patients With Hypertension.
Zeng, Qiang; Li, Yong-Zhe; Dong, Sheng-Yong; Chen, Zong-Tao; Gao, Xiang-Yang; Zhang, Han; Huang, Gang; Xu, Yang.
  • Zeng Q; Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
  • Li YZ; Department of Laboratory Medicine, Peking Union Medical College Hospital, Beijing, China.
  • Dong SY; Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
  • Chen ZT; Health Management Center, The First Affiliated Hospital, Army Medical University, Chongqing, China.
  • Gao XY; Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
  • Zhang H; Health Management Center, Beijing Aerospace General Hospital, Beijing, China.
  • Huang G; Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.
  • Xu Y; Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.
Front Immunol ; 11: 596684, 2020.
Article in English | MEDLINE | ID: covidwho-1000092
ABSTRACT

Background:

The current outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses an unprecedented health crisis. The most common chronic illness among patients infected with SARS-CoV-2 is hypertension. Immune dysregulation plays an important role in SARS-CoV-2 infection and in the development of hypertension; however, the dynamic immunological characteristics of COVID-19 patients with hypertension remain largely unclear.

Methods:

In total, 258 hypertensive patients infected with SARS-CoV-2 were included in this study. CD38+HLA-DR+ and CD38+PD-1+ CD8+ T cells, IFNγ+CD4+ and IFNγ+CD8+ T cells, the titers of IgG, IgM, and IgA against SARS-CoV-2 spike protein, and SARS-CoV-2 throat viral loads were measured weekly over 4 weeks after the onset of symptoms. Clinical outcomes were also monitored.

Findings:

CD4+ T lymphopenia was observed in 100% of the severe and critical cases. Compared with the surviving patients, the patients with fatal outcomes exhibited high and prolonged expression of CD38+HLA-DR+ and CD38+PD-1+ on CD8+ T cells, low expression of SARS-CoV-2-specific IFNγ+CD4+ and IFNγ+CD8+ T cells, low titers of IgG, IgM, and IgA against SARS-CoV-2 spike protein, and high SARS-CoV-2 viral load during the illness. In the surviving patients, the viral load was significantly inversely correlated with SARS-CoV-2-specific IFNγ+CD8+and IFNγ+CD4+ T cells, IgG, IgM, and IgA.

Interpretation:

T lymphopenia is common in critical or severe COVID-19 cases with hypertension. Prolonged activation and exhaustion of CD8+ T cells were associated with severe disease. The delayed SARS-CoV-2-specific antibody responses may be insufficient for overcoming severe SARS-CoV-2 infection in the absence of SARS-CoV-2-specific cellular responses.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: CD4-Positive T-Lymphocytes / CD8-Positive T-Lymphocytes / SARS-CoV-2 / COVID-19 / Hypertension / Antibodies, Viral Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Front Immunol Year: 2020 Document Type: Article Affiliation country: Fimmu.2020.596684

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Full text: Available Collection: International databases Database: MEDLINE Main subject: CD4-Positive T-Lymphocytes / CD8-Positive T-Lymphocytes / SARS-CoV-2 / COVID-19 / Hypertension / Antibodies, Viral Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Front Immunol Year: 2020 Document Type: Article Affiliation country: Fimmu.2020.596684