COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients.

COVID-19 与 5.1% 的死亡率相关。尽管 COVID-19 患者的病毒学、流行病学、临床和治疗结果特征已迅速确定，但炎症和免疫特征仍需要定义，因为它们会影响 COVID-19 的发病机制和临床表达。在这里我们发现，淋巴细胞减少、CD4+T细胞、CD8+T细胞和NK细胞选择性丢失、T细胞过度激活和T细胞抑制分子高表达在重症病例中比轻症病例更为突出。重症患者的 CD8+ T 细胞表达高水平的细胞毒性分子。对一名死亡患者肺组织的组织化学研究显示，SARS-CoV-2 RNA 存在亚解剖学分布，并且 T 细胞和巨噬细胞大量浸润。因此，患有严重 COVID-19 疾病的患者会出现 CD8+ T 细胞的异常激活和失调，这种效应可能与 SARS-CoV-2 感染的发病机制有关，并表明基于免疫的治疗干预目标是治疗严重疾病的一种有希望的治疗方法。 COVID-19 患者。