Aim

Our study's objectives were to study the clinical and laboratory characteristics that may serve as biomarkers for predicting disease severity, IL-10 levels, and frequencies of different T cell subsets in comorbid COVID-19 patients.

Methods

Sixty-two hospitalized COVID-19 patients with comorbidities were assessed clinically and radiologically. Blood samples were collected to assess the T lymphocyte subsets by flow cytometry and IL-10 levels by ELISA.

Results

The most common comorbidities observed in COVID-19 patients were diabetes mellitus (DM), hypertension, and malignancies. Common symptoms and signs included fever, cough, dyspnea, fatigue, myalgia, and sore throat. CRP, ferritin, D dimer, LDH, urea, creatinine, and direct bilirubin were significantly increased in patients than controls. Lymphocyte count and CD4⁺ and CD8⁺ T-cells were significantly decreased in comorbid COVID-19 patients, and CD25 and CD45RA expression were increased. CD4⁺ and CD8⁺ regulatory T cells (Tregs) and IL-10 levels were significantly decreased in patients.

Conclusions

Many parameters were found to be predictive of severity in the comorbid patients in our study. Significant reductions in the levels and activation of CD4⁺ and CD8⁺ T-cells were found. In addition, CD4⁺ and CD8⁺ Tregs were significant decreased in patients, probably pointing to a prominent role of CD8⁺ Tregs in dampening CD4⁺ T-cell activation.

中文翻译：

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合并症患者的 COVID-19 感染：临床和免疫学见解

目标

我们研究的目的是研究临床和实验室特征，这些特征可作为预测 COVID-19 患者疾病严重程度、IL-10 水平和不同 T 细胞亚群频率的生物标志物。

方法

对 62 名有合并症的住院 COVID-19 患者进行了临床和放射学评估。收集血样以通过流式细胞术评估 T 淋巴细胞亚群，并通过 ELISA 评估 IL-10 水平。

结果

在 COVID-19 患者中观察到的最常见合并症是糖尿病 (DM)、高血压和恶性肿瘤。常见的症状和体征包括发烧、咳嗽、呼吸困难、疲劳、肌痛和喉咙痛。与对照组相比，患者的 CRP、铁蛋白、D 二聚体、LDH、尿素、肌酐和直接胆红素显着升高。共病 COVID-19 患者的淋巴细胞计数和 CD4 ⁺和 CD8 ^{+ T 细胞显着降低，CD25 和 CD45RA 表达增加。}患者的CD4 ⁺和 CD8 ⁺调节性 T 细胞 (Tregs) 和 IL-10 水平显着降低。

结论

在我们的研究中，许多参数被发现可以预测合并症患者的严重程度。^{发现 CD4 +}和 CD8 ⁺ T 细胞的水平和活化显着降低。此外，患者的 CD4 ⁺和 CD8 ⁺ Tregs 显着减少，这可能表明 CD8 ⁺ Tregs 在抑制 CD4 ⁺ T 细胞活化方面的重要作用。