Differential alterations in peripheral lymphocyte subsets in COVID-19 patients: upregulation of double-positive and double-negative T cells

Asmaa M. Zahran; Zeinab Albadry M. Zahran; Yasmeen H. Mady; Essam Eldeen M.O. Mahran; Alaa Rashad; Ahmed Makboul; Khalid A. Nasif; Aida A. Abdelmaksoud; Omnia El-Badawy

doi:10.4081/mrm.2021.758

Differential alterations in peripheral lymphocyte subsets in COVID-19 patients: upregulation of double-positive and double-negative T cells

Authors

Asmaa M. Zahran Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut
Zeinab Albadry M. Zahran Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut
Yasmeen H. Mady Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut https://orcid.org/0000-0002-7746-7894
Essam Eldeen M.O. Mahran Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut
Alaa Rashad Department Of Chest Diseases and Tuberculosis, Qena Faculty of Medicine, South Vally-University, Qena https://orcid.org/0000-0003-2727-8187
Ahmed Makboul Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut https://orcid.org/0000-0002-3574-0362
Khalid A. Nasif Department of Biochemistry, Faculty of Medicine, Minia University, Minia
Aida A. Abdelmaksoud Department of E.N.T., Qena Faculty of Medicine, South Valley University, Qena https://orcid.org/0000-0002-5347-0693
Omnia El-Badawy Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut

DOI: https://doi.org/10.4081/mrm.2021.758

Keywords:

COVID-19, SARS-CoV-2, lymphocyte subsets, double-positive T cells, double-negative T cells

Abstract

Background: Viral infections cause alteration in the total number of lymphocytes and their subset distribution. We aimed to study peripheral blood lymphocyte subsets in COVID-19 patients and to correlate these subsets with clinical and laboratory data, which may help in clarifying the pathogenesis to develop novel diagnostic and prognostic biomarkers for COVID-19.
Methods: Twenty-six reverse-transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 patients were subjected to medical history-taking and a thorough clinical examination. Laboratory tests included complete blood count, D dimer, ferritin, and C-reactive protein (CRP). Chest CT was used to diagnose COVID-19 pneumonia. Lymphocyte subsets were compared with those in 20 healthy controls using flow cytometry.
Results: Leucopenia, relative neutrophilia, lymphopenia, eosinopenia together with marked elevation in neutrophil/lymphocyte ratio were observed in our COVID-19 patients. A marked reduction was observed in T cells, including both CD4 and CD8 cells, natural killer (NK), and natural killer T cells (NKT). Double-positive T (DPT) cells, double-negative T (DNT) cells, and B cells were elevated in the patients relative to the other lymphocyte subsets.
Conclusion: Immune-inflammatory parameters are of utmost importance in understanding the pathogenesis and in the provisional diagnosis of COVID-19. Yet, due care must be taken during their interpretation because of the vast discrepancies observed between studies even in the same locality. Further studies are needed to clarify the role of B cells, DPT, and DNT cells in the pathogenesis and control of COVID-19.

Author Biography

Khalid A. Nasif, Department of Biochemistry, Faculty of Medicine, Minia University, Minia

College of Medicine, King Khalid University, Abha, Saudi Arabia

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