Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Zhou, Y. et al.

bioRxiv 2020.02.12.945576 (2020) doi:10.1101/2020.02.12.945576.

Summary

Peripheral blood samples from patients infected by Covid-19 show a decrease in lymphocytes, specifically CD8+T cells in ICU-patients. However, the lymphocytes show a more activated phenotype especially viral exhausted T-cells subsets co-expressing Tim-3 and PD-1. Covid-19 patients show an increase of activated GM-CSF CD4+Th1 cells and inflammatory CD14+CD16+ monocytes with high IL-6 expression. Reported immunological changes are more pronounced in ICU-admitted COVID-19 patients versus non-ICU patients. Data suggests that excessive and aberrant immune cell infiltration as part of an exaggerated immune response results in severe lung pathology. Monoclonal antibodies targeting GM-CSF or IL6 receptor may be viable strategies to curb immunopathology.

Research highlights

  1. Increase of CD4+Th1 cells producing GM-CSF and IL-6 in patients infected with Covid-19
  2. Increase of CD14+CD16+ monocytes with high IL6 expression. Activated immune cells play immune damaging role.
  3. ICU vs non-ICU cases distinguished by high GM-CSF from CD4+ T cells and high IL6 from CD14+ CD16+ monocytes

Research Impact

For serological detection of SARS-COV-2

Yes, they show an increase of cytokines (IL-2, IL-7, IL-10, G-CSF, IP10, MCP-1, MIP1A, TNF-a), an increase in C-reactive protein, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase. A decrease of haemoglobin and albumin.

For treatment of SARS-COV-2 positive individuals

Yes, targeted immunomodulation which reduces the cytokine storm such as monoclonal antibodies that target GM-CSF or IL6 receptor may help ameliorate pulmonary inflammation.

Methodology

Flow cytometry

Strengths and weaknesses of the paper

Strengths:

Work carried out on hospitalised patients with confirmed infection of Covid-19. Patients infected with Covid-19 stratified according to ICU vs non-ICU and compared to healthy controls. Appropriate statistics used and high n numbers (n=10-21). Comparison of cytokine markers from SARS and MERS to Covid-19.

Weaknesses:

Study compares ICU vs non-ICU cases but doesn’t present data representing the majority of COVID19 infections which is asymptomatic or mild.