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Increased circulating level of interleukin-6 and CD8+ T cell exhaustion are associated with progression of COVID-19.
Yang, Peng-Hui; Ding, Yi-Bo; Xu, Zhe; Pu, Rui; Li, Ping; Yan, Jin; Liu, Ji-Luo; Meng, Fan-Ping; Huang, Lei; Shi, Lei; Jiang, Tian-Jun; Qin, En-Qiang; Zhao, Min; Zhang, Da-Wei; Zhao, Peng; Yu, Ling-Xiang; Wang, Zhao-Hai; Hong, Zhi-Xian; Xiao, Zhao-Hui; Xi, Qing; Zhao, De-Xi; Yu, Peng; Zhu, Cai-Zhong; Chen, Zhu; Zhang, Shao-Geng; Ji, Jun-Sheng; Wang, Fu-Sheng; Cao, Guang-Wen.
  • Yang PH; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Ding YB; Department of Epidemiology, Second Military Medical University, Shanghai, 200433, China.
  • Xu Z; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Pu R; Department of Epidemiology, Second Military Medical University, Shanghai, 200433, China.
  • Li P; Department of Epidemiology, Second Military Medical University, Shanghai, 200433, China.
  • Yan J; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Liu JL; Department of Epidemiology, Second Military Medical University, Shanghai, 200433, China.
  • Meng FP; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Huang L; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Shi L; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Jiang TJ; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Qin EQ; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Zhao M; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Zhang DW; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Zhao P; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Yu LX; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Wang ZH; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Hong ZX; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Xiao ZH; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Xi Q; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Zhao DX; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Yu P; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Zhu CZ; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Chen Z; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China.
  • Zhang SG; Department of Hepatobiliary, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China. zhangsg302@hotmail.com.
  • Ji JS; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China. jjs307@sina.com.
  • Wang FS; Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, 100039, China. fswang302@163.com.
  • Cao GW; Department of Epidemiology, Second Military Medical University, Shanghai, 200433, China. gcao@smmu.edu.cn.
Infect Dis Poverty ; 9(1): 161, 2020 Nov 25.
Article in English | MEDLINE | ID: covidwho-949105
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) is pandemic. It is critical to identify COVID-19 patients who are most likely to develop a severe disease. This study was designed to determine the clinical and epidemiological features of COVID-19 patients associated with the development of pneumonia and factors associated with disease progression.

METHODS:

Seventy consecutive patients with etiologically confirmed COVID-19 admitted to PLA General Hospital in Beijing, China from December 27, 2019 to March 12, 2020 were enrolled in this study and followed-up to March 16, 2020. Differences in clinical and laboratory findings between COVID-19 patients with pneumonia and those without were determined by the χ2 test or the Fisher exact test (categorical variables) and independent group t test or Mann-Whitney U test (continuous variables). The Cox proportional hazard model and Generalized Estimating Equations were applied to evaluate factors that predicted the progression of COVID-19.

RESULTS:

The mean incubation was 8.67 (95% confidence interval, 6.78-10.56) days. Mean duration from the first test severe acute respiratory syndrome coronavirus 2-positive to conversion was 11.38 (9.86-12.90) days. Compared to pneumonia-free patients, pneumonia patients were 16.5 years older and had higher frequencies of having hypertension, fever, and cough and higher circulating levels of neutrophil proportion, interleukin-6, low count (< 190/µl) of CD8+ T cells, and neutrophil/lymphocyte ratio. Thirteen patients deteriorated during hospitalization. Cox regression analysis indicated that older age and higher serum levels of interleukin-6, C-reactive protein, procalcitonin, and lactate at admission significantly predicted the progression of COVID-19. During hospitalization, circulating counts of T lymphocytes, CD4+ T cells, and CD8+ T cells were lower, whereas neutrophil proportion, neutrophil/lymphocyte ratio, and the circulating levels of interleukin-6, C-reactive protein, and procalcitonin were higher, in pneumonia patients than in pneumonia-free patients. CD8+ lymphocyte count in pneumonia patients did not recover when discharged.

CONCLUSIONS:

Older age and higher levels of C-reactive protein, procalcitionin, interleukin-6, and lactate might predict COVID-19 progression. T lymphocyte, especially CD8+ cell-mediated immunity is critical in recovery of COVID-19. This study may help in predicting disease progression and designing immunotherapy for COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Interleukin-6 / CD8-Positive T-Lymphocytes / COVID-19 Type of study: Diagnostic study / Etiology study / Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Infect Dis Poverty Year: 2020 Document Type: Article Affiliation country: S40249-020-00780-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Interleukin-6 / CD8-Positive T-Lymphocytes / COVID-19 Type of study: Diagnostic study / Etiology study / Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Infect Dis Poverty Year: 2020 Document Type: Article Affiliation country: S40249-020-00780-6