Qiang Zeng1, Yong-Zhe Li2, Sheng-Yong Dong1, Zong-Tao Chen3, Xiang-Yang Gao1, Han Zhang4, Gang Huang5, Yang Xu5. 1. Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China. 2. Department of Laboratory Medicine, Peking Union Medical College Hospital, Beijing, China. 3. Health Management Center, The First Affiliated Hospital, Army Medical University, Chongqing, China. 4. Health Management Center, Beijing Aerospace General Hospital, Beijing, China. 5. Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.
Abstract
Background: The current outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses an unprecedented health crisis. The most common chronic illness among patients infected with SARS-CoV-2 is hypertension. Immune dysregulation plays an important role in SARS-CoV-2 infection and in the development of hypertension; however, the dynamic immunological characteristics of COVID-19 patients with hypertension remain largely unclear. Methods: In total, 258 hypertensive patients infected with SARS-CoV-2 were included in this study. CD38+HLA-DR+ and CD38+PD-1+ CD8+ T cells, IFNγ+CD4+ and IFNγ+CD8+ T cells, the titers of IgG, IgM, and IgA against SARS-CoV-2 spike protein, and SARS-CoV-2 throat viral loads were measured weekly over 4 weeks after the onset of symptoms. Clinical outcomes were also monitored. Findings: CD4+ T lymphopenia was observed in 100% of the severe and critical cases. Compared with the surviving patients, the patients with fatal outcomes exhibited high and prolonged expression of CD38+HLA-DR+ and CD38+PD-1+ on CD8+ T cells, low expression of SARS-CoV-2-specific IFNγ+CD4+ and IFNγ+CD8+ T cells, low titers of IgG, IgM, and IgA against SARS-CoV-2 spike protein, and high SARS-CoV-2 viral load during the illness. In the surviving patients, the viral load was significantly inversely correlated with SARS-CoV-2-specific IFNγ+CD8+and IFNγ+CD4+ T cells, IgG, IgM, and IgA. Interpretation: T lymphopenia is common in critical or severe COVID-19 cases with hypertension. Prolonged activation and exhaustion of CD8+ T cells were associated with severe disease. The delayed SARS-CoV-2-specific antibody responses may be insufficient for overcoming severe SARS-CoV-2 infection in the absence of SARS-CoV-2-specific cellular responses.
Background: The current outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses an unprecedented health crisis. The most common chronic illness among patientsinfected with SARS-CoV-2 is hypertension. Immune dysregulation plays an important role in SARS-CoV-2 infection and in the development of hypertension; however, the dynamic immunological characteristics of COVID-19patients with hypertension remain largely unclear. Methods: In total, 258 hypertensivepatientsinfected with SARS-CoV-2 were included in this study. CD38+HLA-DR+ and CD38+PD-1+ CD8+ T cells, IFNγ+CD4+ and IFNγ+CD8+ T cells, the titers of IgG, IgM, and IgA against SARS-CoV-2spike protein, and SARS-CoV-2 throat viral loads were measured weekly over 4 weeks after the onset of symptoms. Clinical outcomes were also monitored. Findings: CD4+ T lymphopenia was observed in 100% of the severe and critical cases. Compared with the surviving patients, the patients with fatal outcomes exhibited high and prolonged expression of CD38+HLA-DR+ and CD38+PD-1+ on CD8+ T cells, low expression of SARS-CoV-2-specific IFNγ+CD4+ and IFNγ+CD8+ T cells, low titers of IgG, IgM, and IgA against SARS-CoV-2spike protein, and highSARS-CoV-2 viral load during the illness. In the surviving patients, the viral load was significantly inversely correlated with SARS-CoV-2-specific IFNγ+CD8+and IFNγ+CD4+ T cells, IgG, IgM, and IgA. Interpretation: T lymphopenia is common in critical or severe COVID-19 cases with hypertension. Prolonged activation and exhaustion of CD8+ T cells were associated with severe disease. The delayed SARS-CoV-2-specific antibody responses may be insufficient for overcoming severe SARS-CoV-2 infection in the absence of SARS-CoV-2-specific cellular responses.
Authors: Kenneth W Tsang; Pak L Ho; Gaik C Ooi; Wilson K Yee; Teresa Wang; Moira Chan-Yeung; Wah K Lam; Wing H Seto; Loretta Y Yam; Thomas M Cheung; Poon C Wong; Bing Lam; Mary S Ip; Jane Chan; Kwok Y Yuen; Kar N Lai Journal: N Engl J Med Date: 2003-03-31 Impact factor: 91.245
Authors: Matthew J Cummings; Matthew R Baldwin; Darryl Abrams; Samuel D Jacobson; Benjamin J Meyer; Elizabeth M Balough; Justin G Aaron; Jan Claassen; LeRoy E Rabbani; Jonathan Hastie; Beth R Hochman; John Salazar-Schicchi; Natalie H Yip; Daniel Brodie; Max R O'Donnell Journal: Lancet Date: 2020-05-19 Impact factor: 79.321
Authors: Adam G Laing; Anna Lorenc; Irene Del Molino Del Barrio; Abhishek Das; Matthew Fish; Leticia Monin; Miguel Muñoz-Ruiz; Duncan R McKenzie; Thomas S Hayday; Isaac Francos-Quijorna; Shraddha Kamdar; Magdalene Joseph; Daniel Davies; Richard Davis; Aislinn Jennings; Iva Zlatareva; Pierre Vantourout; Yin Wu; Vasiliki Sofra; Florencia Cano; Maria Greco; Efstathios Theodoridis; Joshua D Freedman; Sarah Gee; Julie Nuo En Chan; Sarah Ryan; Eva Bugallo-Blanco; Pärt Peterson; Kai Kisand; Liis Haljasmägi; Loubna Chadli; Philippe Moingeon; Lauren Martinez; Blair Merrick; Karen Bisnauthsing; Kate Brooks; Mohammad A A Ibrahim; Jeremy Mason; Federico Lopez Gomez; Kola Babalola; Sultan Abdul-Jawad; John Cason; Christine Mant; Jeffrey Seow; Carl Graham; Katie J Doores; Francesca Di Rosa; Jonathan Edgeworth; Manu Shankar-Hari; Adrian C Hayday Journal: Nat Med Date: 2020-08-17 Impact factor: 87.241
Authors: Beatriz Olea; Eliseo Albert; Estela Giménez; Ignacio Torres; Paula Amat; María José Remigia; Juan Alberola; Nieves Carbonell; José Ferreres; María Luisa Blasco; David Navarro Journal: Sci Rep Date: 2022-08-22 Impact factor: 4.996
Authors: Kenneth Lundstrom; Altijana Hromić-Jahjefendić; Esma Bilajac; Alaa A A Aljabali; Katarina Baralić; Nagwa A Sabri; Eslam M Shehata; Mohamed Raslan; Ana Cláudia B H Ferreira; Ángel Serrano-Aroca; Murtaza M Tambuwala; Vladimir N Uversky; Vasco Azevedo; Khalid J Alzahrani; Khalaf F Alsharif; Ibrahim F Halawani; Fuad M Alzahrani; Debmalya Barh Journal: Cell Signal Date: 2022-10-14 Impact factor: 4.850