Inflammatory Profiles and Clinical Features of Coronavirus 2019 Survivors 3 Months After Discharge in Wuhan, China

J Infect Dis. 2021 Nov 16;224(9):1473-1488. doi: 10.1093/infdis/jiab181.

Abstract

Background: Postdischarge immunity and its correlation with clinical features among patients recovered from coronavirus disease 2019(COVID-19) are poorly described. This prospective cross-sectional study explored the inflammatory profiles and clinical recovery of patients with COVID-19 at 3 months after hospital discharge.

Methods: Patients with COVID-19 discharged from 4 hospitals in Wuhan, recovered asymptomatic patients (APs) from an isolation hotel, and uninfected healthy controls (HCs) were recruited. Viral nucleic acid and antibody detection, laboratory examination, computed tomography, pulmonary function assessment, multiplex cytokine assay, and flow cytometry were performed.

Results: The72 age-, sex- and body mass index-matched participants included 19 patients with severe/critical COVID-19 (SPs), 20 patients with mild/moderate COVID-19 (MPs), 16 APs, and 17 HCs. At 3 months after discharge, levels of proinflammatory cytokines and factors related to vascular injury/repair in patients recovered from COVID-19 had not returned to those of the HCs, especially among recovered SPs compared with recovered MPs and APs. These cytokines were significantly correlated with impaired pulmonary function and chest computed tomographic abnormalities. However, levels of immune cells had returned to nearly normal levels and were not significantly correlated with abnormal clinical features.

Conclusion: Vascular injury, inflammation, and chemotaxis persisted in patients with COVID-19 and were correlated with abnormal clinical features 3 months after discharge, especially in recovered SPs.

Keywords: 3 months after discharge; Recovered COVID-19 patients; clinical features; cytokine profiles; immune cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aftercare
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / immunology*
  • COVID-19 / therapy
  • China / epidemiology
  • Cross-Sectional Studies
  • Cytokines / immunology*
  • Humans
  • Patient Discharge
  • Prospective Studies
  • Retrospective Studies
  • SARS-CoV-2
  • Survivors / psychology*
  • Treatment Outcome
  • Vascular System Injuries

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents
  • Cytokines