Immunological and inflammatory profiles in mild and severe cases of COVID-19
Jin‐Wen Song, Chao Zhang, Xing Fan, Fan-Ping Meng, Zhe Xu, Peng Xia, Wen-Jing Cao, Tao Yang, Xiao-Peng Dai, Siyu Wang, Ruo-Nan Xu, Tian-Jun Jiang, Wen-Gang Li, Dawei Zhang, Peng Zhao, Ming Shi, Chiara Agrati, Giuseppe Ippolito, Markus Maeurer, Alimuddin Zumla, Fu‐Sheng Wang, Ji‐Yuan Zhang
Abstract
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.