COVID-19患者淋巴细胞数及Th/Tc值预测病情进展研究

 目的 探讨新型冠状病毒肺炎（COVID-19）患者病情进展与外周血淋巴细胞数（TLC）、CD4⁺T（Th）与CD8⁺T（Tc）比值变化情况，以及TLC和Th/Tc值作为新冠肺炎病情进展监测指标的可行性。方法 收集2020年1月28日—2月10日某院确诊的12例COVID-19患者的实验室检测资料，根据临床症状分为重型/危重型组、轻型/普通型组两组，采用流式细胞仪检测两组患者外周血TLC，比较不同病情患者TLC、Th/Tc值。结果 COVID-19患者TLC占比低于正常值范围，重型/危重型组较轻型/普通型组更低；COVID-19患者Th细胞占比、Th/Tc值高于正常范围，重型/危重型组比轻型/普通型组患者更高。流式检测结果显示，两组患者T淋巴细胞、Th细胞、Tc细胞绝对值均降低，轻型/普通型组、重型/危重型组T淋巴细胞［（913±275）μL VS（526±228）μL］、Th细胞［（530±99）μL VS（351±41）μL］、Tc细胞［（255±84）μL VS（128±70）μL］绝对值比较，差异均有统计学意义（均P<0.05）。结论 通过TLC、Th/Tc的值判断COVID-19患者免疫状态，预测炎症水平，可为监测COVID-19患者疾病进展和确定抗"炎症因子风暴"治疗时机提供依据。

Lymphocyte count and Th/Tc value in predicting disease progress in patients with coronavirus disease 2019

Objective To evaluate disease progress and change in lymphocyte count (TLC), ratio of CD4⁺T(Th)to CD8⁺T(Tc)in peripheral blood in patients with coronavirus disease 2019 (COVID-19), and explore the feasibility of TLC and Th/Tc as monitoring indicator for progress of COVID-19. Methods Laboratory test data of 12 patients who were confirmed with COVID-19 in a hospital between January 28 and February 10, 2020 were collected, according to clinical symptoms, they were divided into severe/critical group and mild/common group, TLC in peripheral blood of two groups of patients was detected by flow cytometry, TLC and Th/Tc values of patients with different disease condition were compared. Results The proportion of TLC of COVID-19 patients was lower than the normal range, severe/critical group was lower than mild/common group; proportion of Th cell and Th/Tc of COVID-19 patients was higher than the normal range, severe/critical group was higher than mild/common group. Flow cytometry result showed that the absolute values of T lymphocyte, Th cell and Tc cell in two groups of patients all decreased, mild/common type group and severe/critical group was significantly different in absolute values of T lymphocyte ([913±275]μL vs[526±228]μL), Th cell ([530±99]μL vs[351±41]μL), and Tc cell ([255±84]μL vs[128±70]μL)(all P<0.05). Conclusion Judging the immune status and predicting inflammatory level of COVID-19 patients by TLC and Th/Tc can provide evidence for monitoring disease progress of COVID-19 and determining treatment opportunity for anti-cytokine storm.