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Correlation of lymphocyte subsets and inflammatory biomarkers with disease severity in COVID-19 patients
Khawar Abbas1, Wajiha Musharraf1, Mirza Naqi Zafar1
1Sindh Institute of Urology, and Transplantation (SIUT), Karachi, Pakistan.
Insights
This study found that lower lymphocyte counts and higher inflammatory markers correlate with severe COVID-19. These findings may help predict disease severity in coronavirus disease-2019 patients.
Area of Science:
- Immunology
- Virology
- Clinical Medicine
Background:
- Coronavirus disease-2019 (COVID-19) poses a significant global health challenge.
- Understanding the immunological factors associated with disease severity is crucial for patient management.
Purpose of the Study:
- To investigate the correlation between lymphocyte subsets and serum inflammatory biomarkers with COVID-19 disease severity.
- To identify potential predictive markers for severe outcomes in COVID-19 patients.
Main Methods:
- A retrospective study analyzed data from 54 COVID-19 patients categorized into severe (Group A) and non-severe (Group B) groups.
- Evaluated complete blood count, neutrophil-to-lymphocytes ratio, C-reactive protein, D-Dimers, serum ferritin, lymphocyte subsets (CD3+, CD4+, CD8+, CD19+, NK cells), and serum cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ).
- Statistical analysis was performed using SPSS 20 to correlate findings with disease severity.
Main Results:
- Severe COVID-19 cases showed significantly reduced levels of CD3+, CD4+, CD8+, and CD19+ T lymphocytes compared to non-severe cases.
- Higher neutrophil-to-lymphocytes ratio was observed in patients who died from severe COVID-19.
- Serum cytokine levels did not show significant differences between severe and non-severe groups.
Conclusions:
- Lymphocyte subset depletion and elevated pro-inflammatory markers are associated with increased COVID-19 severity.
- These immunological changes may serve as indicators for predicting severe disease progression in coronavirus disease-2019.
Objective:
To determine the correlation of lymphocyte subsets and soluble serum inflammatory biomarkers with disease severity in coronavirus disease-2019 infection.
Methods:
The retrospective study was conducted at the Department of Immunology, Sindh Institute of Urology and Transplantation (SIUI), Karachi, Pakistan from September 1 to November 30, 2021, and comprised data of patients admitted from June to July 2021 who tested positive for coronavirus disease-2019 on the basis of reverse transcription-polymerase chain reaction of nasopharyngeal swab specimens. The patients were categorised into severe group A and non-severe group B. Initial investigations included complete blood count, neutrophil-to-lymphocytes ratio, C-reactive protein, D-Dimers and serum ferritin levels. Lymphocyte subsets included cluster of differentiation-3+, cluster of differentiation-4+/ cluster of differentiation-3+, cluster of differentiation-8+ T lymphocytes, cluster of differentiation-19+B lymphocytes, cluster of differentiation-16+ cluster of differentiation-56+ Natural Killer cells and serum cytokine levels of interleukin-2, interleukin- 4, interleukin-6, interleukin-10, tumour necrosis factor-alpha and interferon gamma. They were correlated with disease severity. Data was analysed using SPSS 20.
Results:
Of the 54 patients, 33(61.1%) were males and 21(38.9%) were females. There were 29(53.70%) patients in group A with median age 52 years (interquartile range: 43.5-65 years), and 25(46.29%) in group B with median age 50 years (interquartile range: 36.5-59 years) (p=0.241). Disease was significantly more severe in male patients compared to female (p=0.002). In group A, cluster of differentiation-3+ T cells were reduced in 21(72.4%) patients, cluster of differentiation-8+ T cells in 16(55.2%), cluster of differentiation-4+ T cells in 23(79.3%) and cluster of differentiation-19+ B cells in 8(27.6%). In group B, cluster of differentiation-3+ T cells were reduced in 10(40%) subjects, cluster of differentiation-8+ T cells in 7(28%), cluster of differentiation-4+ T cells in 12(48%) and cluster of differentiation-19+ B cells in 4(16%) patients. Serum cytokine levels were not significantly different between the groups (p>0.05). In group A, 7(24.13%) patients died, and in such cases, the neutrophil-to-lymphocytes ratio was significantly higher (p=0.037).
Conclusion:
Pro-inflammatory markers and cytokine levels increased, while lymphocyte subsets decreased with increasing severity of the disease.
