Comparative study of the lymphocyte change between COVID-19 and non-COVID-19 pneumonia cases suggesting uncontrolled inflammation might not be the main reason of tissue injury
Yishan Zheng, Zhen Huang, Guoping Ying, Xia Zhang, Wei Ye, Zhiliang Hu, Chunmei Hu, Hongxia Wei, Yi Zeng, Yun Chi, Cong Cheng, Feishen Lin, Hu Lu, Lingyan Xiao, Yan Song, Chunming Wang, Yongxiang Yi, Lei Dong
doi: https://doi.org/10.1101/2020.02.19.20024885
Abstract
Background: The 2019 novel coronavirus (COVID-19) emerged in Wuhan in December 2019 and has since rapidly spread across China and to the globe. This virus shows unusually high transmission rate and unique clinical characteristics, with key pathological mechanism remaining unclear. Here, we analysed the laboratory data based on clinical samples from COVID-19 patients, in parallel comparison with non-COVID-19 pneumonia cases, in an attempt to elucidate the key pathological features of COVID-19 during its infection of the human body. Methods: We analysed biochemical indices and lymphocyte subpopulation distribution in the samples of COVID-19 infected patients, and compare the data with those from the pneumonia cases not caused by COVID-19. The study enrolled 125 patients, comprising 103 COVID-19-infected patients and 22 non-COVID-19 pneumonia cases. Laboratory findings were extracted from electronic medical records. Blood was collected for lymphocyte subsets and cytokines determination by flow cytometry analysis. The differences in biochemical indices and lymphocyte subsets distribution between COVID-19-infected and non-COVID-19 pneumonia patients were analyzed. Correlation analysis was performed between leukocyte subgroups count and biochemical indexes relating to organ injury in COVID-19 infected patients (exclude asymptomatic infected cases). Results: We observed significant differences, including abnormal biochemical indices (CRP, LDH, AST, eGFR and sodium ion concentration) and reduced lymphocyte subsets count, between the COVID-19-infected and non-COVID-19-caused pneumonia cases. Correlation analysis indicates that the count for lymphocyte subsets-but not that for neutrophils and monocytes-exhibits a significant negative correlation with biochemical indices relating to organ injury, in the COVID-19 infected patients. Conclusions: The present study indicates significantly different clinical features between COVID-19-caused and non-COVID-19-caused pneumonia, especially in terms of lymphocytopenia and organ injury. Notably, correlation analysis demonstrates that tissue damage in COVID-19 patients is attributed to virus infection itself rather than uncontrolled inflammatory responses ("cytokine storm"). These findings provide new insights for developing efficient therapeutic strategies against COVID-19 infection.
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