当前位置: X-MOL 学术Immun. Ageing › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
COVID-19: age, Interleukin-6, C-reactive protein, and lymphocytes as key clues from a multicentre retrospective study.
Immunity & Ageing ( IF 7.9 ) Pub Date : 2020-08-14 , DOI: 10.1186/s12979-020-00194-w
Aurora Jurado 1 , María C Martín 2 , Cristina Abad-Molina 3 , Antonio Orduña 3 , Alba Martínez 4 , Esther Ocaña 4 , Oscar Yarce 1 , Ana M Navas 1 , Antonio Trujillo 1 , Luis Fernández 5 , Esther Vergara 5 , Beatriz Rodríguez 6 , Bibiana Quirant 7 , Eva Martínez-Cáceres 7 , Manuel Hernández 8 , Janire Perurena-Prieto 8 , Juana Gil 9 , Sergi Cantenys 9 , Gema González-Martínez 10 , María T Martínez-Saavedra 10 , Ricardo Rojo 11 , Francisco M Marco 12 , Sergio Mora 12 , Jesús Ontañón 13 , Marcos López-Hoyos 14 , Gonzalo Ocejo-Vinyals 14 , Josefa Melero 15 , Marta Aguilar 15 , Delia Almeida 16 , Silvia Medina 16 , María C Vegas 17 , Yesenia Jiménez 17 , Álvaro Prada 18 , David Monzón 18 , Francisco Boix 19 , Vanesa Cunill 20 , Juan Molina 1
Affiliation  

The SARS-CoV-2 infection has widely spread to become the greatest public health challenge to date, the COVID-19 pandemic. Different fatality rates among countries are probably due to non-standardized records being carried out by local health authorities. The Spanish case-fatality rate is 11.22%, far higher than those reported in Asia or by other European countries. A multicentre retrospective study of demographic, clinical, laboratory and immunological features of 584 Spanish COVID-19 hospitalized patients and their outcomes was performed. The use of renin-angiotensin system blockers was also analysed as a risk factor. In this study, 27.4% of cases presented a mild course, 42.1% a moderate one and for 30.5% of cases, the course was severe. Ages ranged from 18 to 98 (average 63). Almost 60 % (59.8%) of patients were male. Interleukin 6 was higher as severity increased. On the other hand, CD8 lymphocyte count was significantly lower as severity grew and subpopulations CD4, CD8, CD19, and NK showed concordant lowering trends. Severity-related natural killer percent descents were evidenced just within aged cases. A significant severity-related decrease of CD4 lymphocytes was found in males. The use of angiotensin-converting enzyme inhibitors was associated with a better prognosis. The angiotensin II receptor blocker use was associated with a more severe course. Age and age-related comorbidities, such as dyslipidaemia, hypertension or diabetes, determined more frequent severe forms of the disease in this study than in previous literature cohorts. Our cases are older than those so far reported and the clinical course of the disease is found to be impaired by age. Immunosenescence might be therefore a suitable explanation for the hampering of immune system effectors. The adaptive immunity would become exhausted and a strong but ineffective and almost deleterious innate response would account for COVID-19 severity. Angiotensin-converting enzyme inhibitors used by hypertensive patients have a protective effect in regards to COVID-19 severity in our series. Conversely, patients on angiotensin II receptor blockers showed a severer disease.

中文翻译:

COVID-19:年龄、白细胞介素 6、C 反应蛋白和淋巴细胞作为多中心回顾性研究的关键线索。

SARS-CoV-2 感染已广泛传播,成为迄今为止最大的公共卫生挑战,即 COVID-19 大流行。各国死亡率不同可能是由于当地卫生当局进行的非标准化记录。西班牙的病死率为11.22%,远高于亚洲或其他欧洲国家报告的病死率。对 584 名西班牙 COVID-19 住院患者的人口统计学、临床、实验室和免疫学特征及其结果进行了多中心回顾性研究。肾素-血管紧张素系统阻滞剂的使用也被分析为一个危险因素。在这项研究中,27.4% 的病例为轻度病程,42.1% 为中度病程,30.5% 的病例为重度病程。年龄范围从 18 岁到 98 岁(平均 63 岁)。几乎 60% (59.8%) 的患者是男性。白细胞介素 6 随着严重程度的增加而升高。另一方面,CD8 淋巴细胞计数随着严重程度的增加而显着降低,并且亚群 CD4、CD8、CD19 和 NK 显示出一致的降低趋势。与严重程度相关的自然杀伤百分比下降仅在老年病例中得到证实。在男性中发现了与严重程度相关的 CD4 淋巴细胞显着减少。血管紧张素转换酶抑制剂的使用与更好的预后相关。血管紧张素 II 受体阻滞剂的使用与更严重的病程有关。与以前的文献队列相比,本研究中年龄和年龄相关的合并症,如血脂异常、高血压或糖尿病,决定了该疾病更常见的严重形式。我们的病例比迄今为止报告的病例更早,并且发现该疾病的临床病程因年龄而受损。因此,免疫衰老可能是阻碍免疫系统效应器的合适解释。适应性免疫将耗尽,而强大但无效且几乎有害的先天反应将解释 COVID-19 的严重性。在我们的系列中,高血压患者使用的血管紧张素转换酶抑制剂对 COVID-19 的严重程度具有保护作用。相反,使用血管紧张素 II 受体阻滞剂的患者表现出更严重的疾病。在我们的系列中,高血压患者使用的血管紧张素转换酶抑制剂对 COVID-19 的严重程度具有保护作用。相反,使用血管紧张素 II 受体阻滞剂的患者表现出更严重的疾病。在我们的系列中,高血压患者使用的血管紧张素转换酶抑制剂对 COVID-19 的严重程度具有保护作用。相反,使用血管紧张素 II 受体阻滞剂的患者表现出更严重的疾病。
更新日期:2020-08-14
down
wechat
bug