Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China.
Chuan Qin,Luoqi Zhou,Ziwei Hu,Shuo-Qi Zhang,Sheng Yang,Yu Tao,Cuihong Xie,Ke Ma,Ke Shang,Wei Wang,Dai Shi Tian +10 more
TLDR
Investigation of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis and treatment of COVID-19 and shows the novel coronavirus might mainly act on lymphocytes, especially T lymphocytes.Abstract:
BACKGROUND: In December 2019, coronavirus 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China. METHODS: Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from 10 January to 12 February 2020 were collected and analyzed. The data on laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between patients with severe and nonsevere infection. RESULTS: Of the 452 patients with COVID-19 recruited, 286 were diagnosed as having severe infection. The median age was 58 years and 235 were male. The most common symptoms were fever, shortness of breath, expectoration, fatigue, dry cough, and myalgia. Severe cases tend to have lower lymphocyte counts, higher leukocyte counts and neutrophil-lymphocyte ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines. The number of T cells significantly decreased, and were more impaired in severe cases. Both helper T (Th) cells and suppressor T cells in patients with COVID-19 were below normal levels, with lower levels of Th cells in the severe group. The percentage of naive Th cells increased and memory Th cells decreased in severe cases. Patients with COVID-19 also have lower levels of regulatory T cells, which are more obviously decreased in severe cases. CONCLUSIONS: The novel coronavirus might mainly act on lymphocytes, especially T lymphocytes. Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis, and treatment of COVID-19.read more
Citations
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Imbalanced Host Response to SARS-CoV-2 Drives Development of COVID-19.
Daniel Blanco-Melo,Benjamin E. Nilsson-Payant,Wen-Chun Liu,Skyler Uhl,Daisy A. Hoagland,Rasmus Møller,Tristan X. Jordan,Kohei Oishi,Maryline Panis,David H. Sachs,Taia T. Wang,Robert E. Schwartz,Jean K. Lim,Randy A. Albrecht,Benjamin R. tenOever +14 more
TL;DR: It is proposed that reduced innate antiviral defenses coupled with exuberant inflammatory cytokine production are the defining and driving features of COVID-19.
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The trinity of COVID-19: immunity, inflammation and intervention.
Matthew Zirui Tay,Chek Meng Poh,Laurent Rénia,Laurent Rénia,Paul A. MacAry,Lisa F. P. Ng,Lisa F. P. Ng,Lisa F. P. Ng +7 more
TL;DR: The interaction of SARS-CoV-2 with the immune system and the subsequent contribution of dysfunctional immune responses to disease progression is described and the implications of these approaches for potential therapeutic interventions that target viral infection and/or immunoregulation are highlighted.
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Extrapulmonary manifestations of COVID-19.
Aakriti Gupta,Aakriti Gupta,Mahesh V. Madhavan,Kartik Sehgal,Kartik Sehgal,Nandini Nair,Shiwani Mahajan,Tejasav S. Sehrawat,Behnood Bikdeli,Behnood Bikdeli,Neha Ahluwalia,John C. Ausiello,Elaine Wan,Daniel E. Freedberg,Ajay J. Kirtane,Sahil A. Parikh,Mathew S. Maurer,Anna S. Nordvig,Domenico Accili,Joan M. Bathon,Sumit Mohan,Kenneth A. Bauer,Kenneth A. Bauer,Martin B. Leon,Harlan M. Krumholz,Nir Uriel,Mandeep R. Mehra,Mitchell S.V. Elkind,Mitchell S.V. Elkind,Gregg W. Stone,Allan Schwartz,David D. Ho,John P. Bilezikian,Donald W. Landry +33 more
TL;DR: The extrapulmonary organ-specific pathophysiology, presentations and management considerations for patients with COVID-19 are reviewed to aid clinicians and scientists in recognizing and monitoring the spectrum of manifestations, and in developing research priorities and therapeutic strategies for all organ systems involved.
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Multisystem Inflammatory Syndrome in U.S. Children and Adolescents.
Leora R. Feldstein,Leora R. Feldstein,Erica B. Rose,Erica B. Rose,Steven M. Horwitz,Jennifer P. Collins,Margaret M Newhams,Mary Beth F. Son,Jane W. Newburger,Lawrence C. Kleinman,Sabrina M. Heidemann,Amarilis A. Martin,Aalok R. Singh,Simon Li,Keiko M. Tarquinio,Preeti Jaggi,Matthew E. Oster,Sheemon P. Zackai,Jennifer K. Gillen,Adam J. Ratner,Rowan Walsh,Julie C. Fitzgerald,Michael A. Keenaghan,Hussam Alharash,Sule Doymaz,Katharine N. Clouser,John S. Giuliano,Anjali Gupta,Robert M. Parker,Aline B Maddux,Vinod Havalad,Stacy Ramsingh,Hulya Bukulmez,Tamara T. Bradford,Lincoln S. Smith,Mark W Tenforde,Christopher L. Carroll,Becky J. Riggs,Shira J. Gertz,Ariel Daube,Amanda N Lansell,Alvaro Coronado Munoz,Charlotte V. Hobbs,Kimberly Marohn,Natasha B. Halasa,Manish M. Patel,Manish M. Patel,Adrienne G. Randolph +47 more
TL;DR: Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents.
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Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages.
Miriam Merad,Jerome Martin +1 more
TL;DR: The potentially pathological roles of macrophages during SARS-CoV-2 infection are described and ongoing and prospective therapeutic strategies to modulate macrophage activation in patients with COVID-19 are discussed.
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