Apoptosis and immunophenotyping of peripheral blood lymphocytes in Iranian COVID-19 patients: Clinical and laboratory characteristics

J Med Virol. 2021 Mar;93(3):1589-1598. doi: 10.1002/jmv.26505. Epub 2020 Sep 28.

Abstract

A novel member of human coronavirus, named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been recently recognized in China and rapidly spread worldwide. Studies showed the decreasing of peripheral blood lymphocytes in a majority of patients. In this study, we have reported the clinical features, laboratory characteristics, the frequency of peripheral blood lymphocyte subpopulations, and their apoptosis pattern in Iranian coronavirus infectious disease (COVID-19) patients. Demographic and clinical data of 61 hospitalized confirmed cases with COVID-19 at Imam Khomeini Hospital were collected and analyzed. Peripheral blood mononuclear cells were isolated from all samples and the apoptosis pattern was evaluated using Annexin V/propidium iodide method. The frequency of lymphocyte subsets, including T-CD4+ , T-CD8+ , NK, B cells, and monocytes, was measured in all patients and 31 controls by flow cytometry. Our findings demonstrated that the percentage of lymphocytes, CD4+ , and CD8+ T cells were decreased in COVID-19 patients compared with the control group. Regarding the clinical severity, the number of lymphocytes, CD4+ , CD8+ T cells, and NK cells were also decreased in severe cases when compared with mild cases. Finally, our data have also indicated the increase in apoptosis of mononuclear cells from COVID-19 patients which was more remarkable in severe clinical cases. The frequency of immune cells is a useful indicator for prediction of severity and prognosis of COVID-19 patients. These results could help to explain the immunopathogenesis of SARS-CoV-2 and introducing novel biomarkers, therapeutic strategies, and vaccine candidates.

Keywords: COVID-19; Iran; apoptosis; lymphocyte subpopulations; lymphopenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Apoptosis / immunology
  • B-Lymphocytes / cytology*
  • Biomarkers / blood
  • CD4-Positive T-Lymphocytes / cytology*
  • CD8-Positive T-Lymphocytes / cytology*
  • COVID-19 / immunology
  • Female
  • Flow Cytometry
  • Humans
  • Immunophenotyping / methods*
  • Iran
  • Killer Cells, Natural / cytology*
  • Lymphocyte Count
  • Lymphopenia / immunology
  • Male
  • Middle Aged
  • SARS-CoV-2 / immunology*

Substances

  • Biomarkers