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Published on: February 16, 2022
Dynamic monitoring of immune function indexes in COVID-19 patients
Yaohui Song1, Huixiu Zhong1, Lin Li2
1Department of Clinical Laboratory, Zigong First People’s Hospital, Zigong 643000, Sichuan, China.
Insights
This study on COVID-19 patients found that immune markers like CRP and CD4/CD8 lymphocyte counts can aid early diagnosis. SARS-CoV-2 antibody levels, particularly IgG, remain elevated long-term, guiding treatment like plasma exchange.
Area of Science:
- Immunology
- Infectious Diseases
- Clinical Medicine
Background:
- The clinical and immunological profiles of COVID-19 patients require further elucidation.
- Understanding dynamic immune variations is crucial for diagnosis and treatment guidance.
Purpose of the Study:
- To analyze the clinical characteristics and dynamic immune index variations in COVID-19 patients.
- To identify potential early diagnostic markers for SARS-CoV-2 infection.
- To investigate the correlation between SARS-CoV-2 infection and allergic immune responses.
Main Methods:
- Retrospective analysis of nine COVID-19 patients.
- Flow cytometry to measure absolute CD4 and CD8 lymphocyte counts.
- Enzyme-linked immunosorbent assays (ELISA) to quantify SARS-CoV-2 antibodies (IgM, IgG) and IgE levels.
- Monitoring of C-reactive protein (CRP), lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), and plasma activity (PA).
Main Results:
- Elevated levels of CRP, LDH, HBDH, CD4/CD8 ratio, and IgE were observed in 6/9 patients.
- Decreased PA and absolute CD4/CD8 lymphocyte counts were noted in 7/9 patients.
- SARS-CoV-2 IgG levels remained consistently higher than IgM, with IgG persisting beyond 63 days post-onset.
- IgE levels mirrored SARS-CoV-2 IgM dynamics, suggesting a potential link to allergic responses.
Conclusions:
- CRP, PA, LDH, HBDH, and CD4/CD8 lymphocyte counts may serve as early diagnostic markers for SARS-CoV-2 infection.
- SARS-CoV-2 infection might trigger allergic immune responses.
- Dynamic monitoring of SARS-CoV-2 antibodies can inform the timing for therapeutic plasma exchange.
Abstract:
We conducted a retrospective analysis of the clinical characteristics and dynamic variations of immune indexes in nine COVID-19 patients in Zigong, China. We used flow cytometry and enzyme-linked immunosorbent assays to measure the absolute levels of CD4 and CD8 lymphocytes and SARS-CoV-2 antibodies, respectively. We found that CRP, LDH, HBDH, CD4/CD8 and IgE levels were increased in 6/9 patients, while PA and the absolute numbers of CD4 and CD8 lymphocytes decreased in 7/9 patients. From disease onset through 63 days of follow-up, SARS-CoV-2 IgG levels were consistently higher than those of SARS-CoV-2 IgM, reaching peaks on days 28 and 13, respectively. IgM levels decreased to normal 35 days after disease onset, while IgG levels remained elevated through day 63. IgE levels varied similarly to SARS-CoV-2 IgM. Our results suggest that SARS-CoV-2 may elicit allergic immune responses in patients and that the levels of CRP, PA, LDH, and HBDH, as well as the absolute numbers of CD4 and CD8 lymphocytes could be used as early diagnostic markers of SARS-CoV-2 infection. Lastly, the dynamic variation of SARS-CoV-2 antibodies could guide the timing of blood collection for plasma exchange.
