Reduction and exhausted features of T lymphocytes under serological changes, and prognostic factors in COVID-19 progression

Mol Immunol. 2021 Oct:138:121-127. doi: 10.1016/j.molimm.2021.06.001. Epub 2021 Aug 6.

Abstract

Aims: Coronavirus disease 2019 (COVID-19) is a novel viral infection threatening worldwide health as currently there exists no effective treatment strategy and vaccination programs are not publicly available yet. T lymphocytes play an important role in antiviral defenses. However, T cell frequency and functionality may be affected during the disease.

Material and methods: Total blood samples were collected from patients with mild and severe COVID-19, and the total lymphocyte number, as well as CD4+ and CD8 + T cells were assessed using flowcytometry. Besides, the expression of exhausted T cell markers was evaluated. The levels of proinflammatory cytokines were also investigated in the serum of all patients using enzyme-linked immunesorbent assay (ELISA). Finally, the obtained results were analyzed along with laboratory serological reports.

Results: COVID-19 patients showed lymphopenia and reduced CD4+ and CD8 + T cells, as well as high percentage of PD-1 expression by T cells, especially in severe cases. Serum secretion of TNF-α, IL-1β, and IL-2 receptor (IL-2R) were remarkably increased in patients with severe symptoms, as compared with healthy controls. Moreover, high levels of triglyceride (TG) and low density lipoprotein cholesterol (LDL-C), were correlated with the severity of the disease.

Conclusion: Reduced number and function of T cells were observed in COVID-19 patients, especially in severe patients. Meanwhile, the secretion of proinflammatory cytokines was increased as the disease developed. High level of serum IL-2R was also considered as a sign of lymphopenia. Additionally, hypercholesterolemia and hyperlipidemia could be important prognostic factors in determining the severity of the infection.

Keywords: COVID-19; Cytokine; Exhaustion; Inflammation; T cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • CD4-Positive T-Lymphocytes / immunology*
  • CD4-Positive T-Lymphocytes / metabolism
  • CD4-Positive T-Lymphocytes / virology
  • CD8-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / virology
  • COVID-19 / immunology*
  • COVID-19 / metabolism
  • COVID-19 / virology
  • Cholesterol, LDL / blood
  • Cytokines / blood
  • Cytokines / immunology
  • Cytokines / metabolism
  • Disease Progression
  • Female
  • Humans
  • Lymphocyte Count
  • Lymphopenia / blood
  • Lymphopenia / immunology*
  • Lymphopenia / virology
  • Male
  • Middle Aged
  • Prognosis
  • SARS-CoV-2 / immunology*
  • SARS-CoV-2 / physiology
  • Severity of Illness Index
  • Triglycerides / blood

Substances

  • Cholesterol, LDL
  • Cytokines
  • Triglycerides