COVID-19: age, Interleukin-6, C-reactive protein, and lymphocytes as key clues from a multicentre retrospective study.

Autor: Jurado A; Department of Immunology and Allergology, Hospital Universitario Reina Sofía-Instituto de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain., Martín MC; Centro de Hemoterapia y Hemodonación de Castilla y León, Paseo de Filipinos s/n, 47007 Valladolid, Spain., Abad-Molina C; Department of Microbiology and Immunology, Hospital Clínico Universitario, Valladolid, Spain., Orduña A; Department of Microbiology and Immunology, Hospital Clínico Universitario, Valladolid, Spain., Martínez A; Laboratory Unit. Complejo Hospitalario, Jaén, Spain., Ocaña E; Laboratory Unit. Complejo Hospitalario, Jaén, Spain., Yarce O; Department of Immunology and Allergology, Hospital Universitario Reina Sofía-Instituto de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain., Navas AM; Department of Immunology and Allergology, Hospital Universitario Reina Sofía-Instituto de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain., Trujillo A; Department of Immunology and Allergology, Hospital Universitario Reina Sofía-Instituto de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain., Fernández L; Laboratoy of Immunology and Genetics. Hospital San Pedro de Alcántara, Cáceres, Spain., Vergara E; Laboratoy of Immunology and Genetics. Hospital San Pedro de Alcántara, Cáceres, Spain., Rodríguez B; Laboratory Unit. Hospital Juan Ramón Jiménez, Huelva, Spain., Quirant B; Department of Immunology, Hospital Germans Trias i Pujols, Barcelona, Spain., Martínez-Cáceres E; Department of Immunology, Hospital Germans Trias i Pujols, Barcelona, Spain., Hernández M; Department of Immunology, Hospital Universitario Vall d'Hebron, Barcelona, Spain., Perurena-Prieto J; Department of Immunology, Hospital Universitario Vall d'Hebron, Barcelona, Spain., Gil J; Department of Immunology, Hospital General Universitario e Instituto de Investigación Sanitaria 'Gregorio Marañón', Madrid, Spain., Cantenys S; Department of Immunology, Hospital General Universitario e Instituto de Investigación Sanitaria 'Gregorio Marañón', Madrid, Spain., González-Martínez G; Unit of Immunology, Hospital Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain., Martínez-Saavedra MT; Unit of Immunology, Hospital Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain., Rojo R; Department of Immunology, Complejo Hospitalario, La Coruña, Spain., Marco FM; Laboratory Unit. Hospital General, Alicante, Spain., Mora S; Laboratory Unit. Hospital General, Alicante, Spain., Ontañón J; Laboratory Unit. Hospital General Universitario, Albacete, Spain., López-Hoyos M; Department of Immunology, Hospital Universitario Marqués de Valdecilla, Santander, Spain., Ocejo-Vinyals G; Department of Immunology, Hospital Universitario Marqués de Valdecilla, Santander, Spain., Melero J; Department of Immunology, Hospital Infanta Cristina, Badajoz, Spain., Aguilar M; Department of Immunology, Hospital Infanta Cristina, Badajoz, Spain., Almeida D; Laboratory Unit. Complejo Hospitalario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain., Medina S; Laboratory Unit. Complejo Hospitalario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain., Vegas MC; Department of Immunology, Fundación Jiménez Díaz, Madrid, Spain., Jiménez Y; Department of Immunology, Fundación Jiménez Díaz, Madrid, Spain., Prada Á; Department of Immunology, Hospital de Donostia, San Sebastián, Spain., Monzón D; Department of Immunology, Hospital de Donostia, San Sebastián, Spain., Boix F; Department of Immunology, Hospital Clínico Universitario, Salamanca, Spain., Cunill V; Department of Immunology, Hospital Universitario Son Espases, Palma de Mallorca, Spain., Molina J; Department of Immunology and Allergology, Hospital Universitario Reina Sofía-Instituto de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.
Jazyk: angličtina
Zdroj: Immunity & ageing : I & A [Immun Ageing] 2020 Aug 14; Vol. 17, pp. 22. Date of Electronic Publication: 2020 Aug 14 (Print Publication: 2020).
DOI: 10.1186/s12979-020-00194-w
Abstrakt: Background: The SARS-CoV-2 infection has widely spread to become the greatest public health challenge to date, the COVID-19 pandemic. Different fatality rates among countries are probably due to non-standardized records being carried out by local health authorities. The Spanish case-fatality rate is 11.22%, far higher than those reported in Asia or by other European countries. A multicentre retrospective study of demographic, clinical, laboratory and immunological features of 584 Spanish COVID-19 hospitalized patients and their outcomes was performed. The use of renin-angiotensin system blockers was also analysed as a risk factor.
Results: In this study, 27.4% of cases presented a mild course, 42.1% a moderate one and for 30.5% of cases, the course was severe. Ages ranged from 18 to 98 (average 63). Almost 60 % (59.8%) of patients were male. Interleukin 6 was higher as severity increased. On the other hand, CD8 lymphocyte count was significantly lower as severity grew and subpopulations CD4, CD8, CD19, and NK showed concordant lowering trends. Severity-related natural killer percent descents were evidenced just within aged cases. A significant severity-related decrease of CD4 lymphocytes was found in males. The use of angiotensin-converting enzyme inhibitors was associated with a better prognosis. The angiotensin II receptor blocker use was associated with a more severe course.
Conclusions: Age and age-related comorbidities, such as dyslipidaemia, hypertension or diabetes, determined more frequent severe forms of the disease in this study than in previous literature cohorts. Our cases are older than those so far reported and the clinical course of the disease is found to be impaired by age. Immunosenescence might be therefore a suitable explanation for the hampering of immune system effectors. The adaptive immunity would become exhausted and a strong but ineffective and almost deleterious innate response would account for COVID-19 severity. Angiotensin-converting enzyme inhibitors used by hypertensive patients have a protective effect in regards to COVID-19 severity in our series. Conversely, patients on angiotensin II receptor blockers showed a severer disease.
Competing Interests: Competing interestsThe authors stated no conflicts of interest.
(© The Author(s) 2020.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje