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      T cell subset counts in peripheral blood can be used as discriminatory biomarkers for diagnosis and severity prediction of COVID-19

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          Abstract

          This study evaluated the significance of lymphocyte subsets detection in peripheral blood in the diagnosis and prognosis of coronavirus disease 2019 (COVID-19). Our results revealed that CD3+T, CD4+T, CD8+T cells and NK cells were significantly decreased in COVID-19 patients. COVID-19 patients had a relatively slight decrease in CD4+T cells but a severe decrease of CD8+T cells. The significantly elevated CD4/CD8 ratio was observed in COVID-19 patients. T cell subset counts were related to the severity and prognosis of COVID-19. The counts of CD8+T and CD4+T cells can be used as diagnostic markers of COVID-19 and predictors of disease severity.

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          Most cited references9

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          An interferon‐γ‐related cytokine storm in SARS patients †

          Abstract Fourteen cytokines or chemokines were analyzed on 88 RT‐PCR‐confirmed severe acute respiratory syndrome (SARS) patients. IFN‐γ, IL‐18, TGF‐β, IL‐6, IP‐10, MCP‐1, MIG, and IL‐8, but not of TNF‐α, IL‐2, IL‐4, IL‐10, IL‐13, or TNFRI, were highly elevated in the acute phase sera of Taiwan SARS patients. IFN‐γ was significantly higher in the Ab(+) group than in the Ab(−) group. IFN‐γ, IL‐18, MCP‐1, MIG, and IP‐10 were already elevated at early days post fever onset. Furthermore, levels of IL‐18, IP‐10, MIG, and MCP‐1 were significantly higher in the death group than in the survival group. For the survival group, IFN‐γ and MCP‐1 were inversely associated with circulating lymphocytes count and monocytes count, but positively associated with circulating neutrophils count. It is concluded that an interferon‐γ‐related cytokine storm was induced post SARS coronavirus infection, and this cytokine storm might be involved in the immunopathological damage in SARS patients. J. Med. Virol. 75:185–194, 2005. © 2004 Wiley‐Liss, Inc.
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            Significant Changes of Peripheral T Lymphocyte Subsets in Patients with Severe Acute Respiratory Syndrome

            This report demonstrates that a rapid decrease of peripheral T cell subsets is a unique characteristic in patients with SARS during acute infection, although total white blood cell counts, red blood cell counts, and platelet counts remain relatively normal. In recovering patients, a rapid and dramatic restoration of peripheral T cell subsets was seen in the periphery. Although the underlying mechanism of the acute decrease of peripheral T cell subsets observed in patients with SARS during the acute stage remains unknown, this clinical characteristic can facilitate an earlier and more accurate diagnosis of SARS.
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              T cells with a CD4+CD25+ regulatory phenotype suppress in vitro proliferation of virus-specific CD8+ T cells during chronic hepatitis C virus infection.

              Chronic hepatitis C virus (HCV) infection is associated with impaired proliferative, cytokine, and cytotoxic effector functions of HCV-specific CD8(+) T cells that probably contribute significantly to viral persistence. Here, we investigated the potential role of T cells with a CD4(+)CD25(+) regulatory phenotype in suppressing virus-specific CD8(+) T-cell proliferation during chronic HCV infection. In vitro depletion studies and coculture experiments revealed that peptide specific proliferation as well as gamma interferon production of HCV-specific CD8(+) T cells were inhibited by CD4(+)CD25(+) T cells. This inhibition was dose dependent, required direct cell-cell contact, and was independent of interleukin-10 and transforming growth factor beta. Interestingly, the T-cell-mediated suppression in chronically HCV-infected patients was not restricted to HCV-specific CD8(+) T cells but also to influenza virus-specific CD8(+) T cells. Importantly, CD4(+)CD25(+) T cells from persons recovered from HCV infection and from healthy blood donors exhibited significantly less suppressor activity. Thus, the inhibition of virus-specific CD8(+) T-cell proliferation was enhanced in chronically HCV-infected patients. This was associated with a higher frequency of circulating CD4(+)CD25(+) cells observed in this patient group. Taken together, our results suggest that chronic HCV infection leads to the expansion of CD4(+)CD25(+) T cells that are able to suppress CD8(+) T-cell responses to different viral antigens. Our results further suggest that CD4(+)CD25(+) T cells may contribute to viral persistence in chronically HCV-infected patients and may be a target for immunotherapy of chronic hepatitis C.
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                Author and article information

                Journal
                J Infect Dis
                J. Infect. Dis
                jid
                The Journal of Infectious Diseases
                Oxford University Press (US )
                0022-1899
                1537-6613
                07 May 2020
                : jiaa252
                Affiliations
                [1 ] Department of Clinical Laboratory, the First Affiliated Hospital of Nanchang University
                [2 ] Department of Transfusion, the First Affiliated Hospital of Nanchang University
                Author notes
                Correspondence to: Dr Lagen Wan, Dr Junming Li, Department of Clinical Laboratory, the First Affiliated Hospital of Nanchang University, 17 Yongwai Zheng Jie, Nanchang, Jiangxi 330006, P.R. China Email: wlgme196412@ 123456126.com , lisir361@ 123456163.com or Dr AiPing Le, Department of Transfusion, the First Affiliated Hospital of Nanchang University, 17 Yongwai Zheng Jie, Nanchang, Jiangxi 330006, P.R. China E-mail: leaiping@ 123456126.com

                Mei Jiang and Yang Guo contributed equally

                Article
                jiaa252
                10.1093/infdis/jiaa252
                7239156
                32379887
                d17d6ded-907f-41ec-956e-8f2d32f64450
                © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

                This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                : 17 March 2020
                Categories
                Brief Report
                AcademicSubjects/MED00860
                AcademicSubjects/MED00290
                Custom metadata
                PAP
                accepted-manuscript

                Infectious disease & Microbiology
                sars-cov2,lymphocyte subsets,diagnosis,prognosis
                Infectious disease & Microbiology
                sars-cov2, lymphocyte subsets, diagnosis, prognosis

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