Evaluation of lymphocyte subtypes in COVID-19 patients

  1. Mitra Rezaei
  2. Majid Marjani
  3. Payam Tabarsi
  4. Afshin Moniri
  5. Mihan purabdollah
  6. Zahra Abtahian
  7. Mehdi Kazempour Dizaji
  8. Neda Dalil Roofchayee
  9. Neda K. Dezfuli
  10. Davood Mansouri
  11. Nikoo Hossein-Khannazer
  12. Mohamad Varahram
  13. Esmaeil Mortaz
  14. Ali Akbar Velayati

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Abstract

Background

Although the many aspects of COVID-19 have not been yet recognized, it seems that the dysregulation of the immune system has a very important role in the progression of the disease. In this study the lymphocyte subsets were evaluated in COVID-19 patients with different severity.

Methods

In this prospective study, the levels of peripheral lymphocyte subsets (CD3 + , CD4 + , CD8 + T cells; CD19 + and CD20 + B cells; CD16 + /CD56 + NK cells, and CD4 + /CD25 + /FOXP3 + regulatory T cells) were measured in 67 confirmed patients with COVID-19 on the first day of admission.

Results

The mean age of cases was 51.3 ± 14.8 years. Thirty-two patients (47.8%) were classified as severe cases and 11 (16.4%) patients were categorized as critical. The frequency of blood lymphocytes, CD3 + cells, CD25 + FOXP3 + T cells; and absolute count of CD3 + T cells, CD25 + FOXP3 + T cells, CD4 + T cells, CD8 + T cells, CD16 + 56 + lymphocytes were lower in more severe cases in comparison to milder cases. Percentages of lymphocytes, T cells, and NK cells were significantly lower inthe patients who died (p= 0.002 and P= 0.042, p=0.006, respectively).

Conclusion

Findings of this cohort study suggests that the frequency of CD4 + , CD8 + , CD25 + FOXP3 + T cells, and NK cells were difference in the severe COVID-19 patients. Moreover, lower frequency of, T cells, and NK cells are predictors of mortality of these patients.

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  1. ScreenIT

    SciScore for 10.1101/2021.07.12.21260382: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study protocol was approved by the Ethics Committee of the national research institute of tuberculosis and lung diseases (approval number: IR.SBMU.NRITLD.REC.1399.037).
    Consent: Written informed consent was obtained from all participants or their legal guardians.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Antibodies which is used for flow cytometry were phycoerythrin (PE)-conjugated anti-human CD4, CD19, CD16/56 antibodies (PharMingen, USA) to staining CD4 T cells, CD19 for B cells, CD16/56 for NK cells, respectively.
    anti-human CD4
    suggested: None
    CD19
    suggested: None
    CD16/56
    suggested: (Acris Antibodies GmbH Cat# SM2170F, RRID:AB_1005717)
    CD8 cells were stained by anti -human CD8 conjugated with allophycocyanin (APC) antibody.
    anti -human CD8
    suggested: None
    allophycocyanin ( APC
    suggested: None
    (FITC)-conjugated anti-human antibody (PharMingen, USA) was used.
    anti-human antibody
    suggested: None
    Software and Algorithms
    SentencesResources
    The data was analyzed by flowjo software version 8.
    flowjo
    suggested: (FlowJo, RRID:SCR_008520)
    SPSS Statistics version 21.0 software was used for statistical analyses.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    In summary the current study has limitations due to the variability and diverse future of COVID-19 which unable to generalize the statement. Concerning the complexity of the immune system, prospective multicenter studies with a large sample of patients need to be studied. Besides, analysis of cellular subsets in detail with multi-colored staining of subsets of T cells such as Th9, Th17 and Th22 T cells are necessary to assess the time-based changes in immune response after infection with SARS-Co-V-2 and their prognostic value. In conclusion, our data suggests that the counts of total lymphocyte and their immunophenotyping (consisting of CD4 +, CD8+, CD25+FOXP3+ T cells, and NK cells) may be correlated with the severity of COVID-19 patients. The reduction of these cells may suggests for usage on them as the predictors of the severity of the disease, however, need to be explored in detail in the future.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.07.12.21260382v1 on medRxiv