• Frontiers in immunology · Jan 2020

    Early Phases of COVID-19 Are Characterized by a Reduction in Lymphocyte Populations and the Presence of Atypical Monocytes.

    • Andrea Lombardi, Elena Trombetta, Alessandra Cattaneo, Valeria Castelli, Emanuele Palomba, Mario Tirone, Davide Mangioni, Giuseppe Lamorte, Maria Manunta, Daniele Prati, Ferruccio Ceriotti, Roberta Gualtierotti, Giorgio Costantino, Stefano Aliberti, Vittorio Scaravilli, Giacomo Grasselli, Andrea Gori, Laura Porretti, and Alessandra Bandera.
    • Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
    • Front Immunol. 2020 Jan 1; 11: 560330.

    BackgroundSevere acute respiratory syndrome coronavirus 2 is a recently discovered pathogen responsible of coronavirus disease 2019 (COVID-19). The immunological changes associated with this infection are largely unknown.MethodsWe evaluated the peripheral blood mononuclear cells profile of 63 patients with COVID-19 at diagnosis. We also assessed the presence of association with inflammatory biomarkers and the 28-day mortality.ResultsLymphocytopenia was present in 51 of 63 (80.9%) patients, with a median value of 720 lymphocytes/µl (IQR 520-1,135). This reduction was mirrored also on CD8+ (128 cells/µl, IQR 55-215), natural killer (67 cells/µl, IQR 35-158) and natural killer T (31 cells/µl, IQR 11-78) cells. Monocytes were preserved in total number but displayed among them a subpopulation with a higher forward and side scatter properties, composed mainly of cells with a reduced expression of both CD14 and HLA-DR. Patients who died in the 28 days from admission (N=10, 15.9%), when compared to those who did not, displayed lower mean values of CD3+ (337.4 cells/µl vs 585.9 cells/µl; p=0.028) and CD4+ cells (232.2 cells/µl vs 381.1 cells/µl; p=0.042) and an higher percentage of CD8+/CD38+/HLA-DR+ lymphocytes (13.5% vs 7.6%; p=0.026).DiscussionThe early phases of COVID-19 are characterized by lymphocytopenia, predominance of Th2-like lymphocytes and monocytes with altered immune profile, which include atypical mononuclear cells.Copyright © 2020 Lombardi, Trombetta, Cattaneo, Castelli, Palomba, Tirone, Mangioni, Lamorte, Manunta, Prati, Ceriotti, Gualtierotti, Costantino, Aliberti, Scaravilli, Grasselli, Gori, Porretti and Bandera.

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