Long-term infection of SARS-CoV-2 changed the body's immune status

Lan Lin; Shanshan Luo; Renjie Qin; Mengling Yang; Xiaobei Wang; Qianqian Yang; Yang Zhang; Quansheng Wang; Rui Zhu; Heng Fan; Haijun Wang; Yu Hu; Lin Wang; Desheng Hu

doi:10.1016/j.clim.2020.108524

Long-term infection of SARS-CoV-2 changed the body's immune status

Clin Immunol. 2020 Sep:218:108524. doi: 10.1016/j.clim.2020.108524. Epub 2020 Jul 11.

Authors

Lan Lin¹, Shanshan Luo², Renjie Qin¹, Mengling Yang¹, Xiaobei Wang³, Qianqian Yang³, Yang Zhang³, Quansheng Wang¹, Rui Zhu¹, Heng Fan¹, Haijun Wang⁴, Yu Hu⁵, Lin Wang⁶, Desheng Hu⁷

Affiliations

¹ Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
² Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
³ Department of Clinical laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
⁴ Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
⁵ Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. Electronic address: dr_huyu@126.com.
⁶ Department of Clinical laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. Electronic address: lin_wang@hust.edu.cn.
⁷ Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. Electronic address: desheng.hu@hust.edu.cn.

Abstract

The outbreak of SARS-CoV-2-associated pneumonia, a disease called COVID-19, has caused a pandemic worldwide. To investigate the immune responses after infection of SARS-CoV-2 in non-critical patients may help to better understand the disease progression. We collected 334 confirmed COVID-19 cases including 212 still in hospital with nucleic acid test positive on halfway for SARS-CoV-2 and 122 discharged from hospital, compared specific antibodies, immune cells, and cytokine changes between the hospitalized and discharged patients. The hospitalized patients had a longer illness time compared with discharged patients. Analysis of viral loads explained long-term or persistent infection of SARS-CoV-2, which existed with the median time of 18.5 days of the positive nucleic acid test. Serum analysis showed that the specific anti-N IgG antibody was positive in all detected patients after infection of two weeks. Neutrophils, Monocytes, NK cells, and CD4⁺ T cells significantly increased, while total lymphocytes and CD8⁺ T cells decreased from non-critical hospitalized patients after longer-term infection. Further analysis of the cytokines showed that IL-6, TNF-α, IFN-γ, IL-2, IL-4, and IL-10 from the hospitalized patients were significantly higher, indicating a potential of the increased CD4⁺ T cell differentiation.

Keywords: Immune response; Long-term infection; SARS-CoV-2.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Antibodies, Viral / blood
Betacoronavirus / immunology
Betacoronavirus / pathogenicity*
COVID-19
Cardiovascular Diseases / epidemiology
Cardiovascular Diseases / immunology*
Cardiovascular Diseases / pathology
Cardiovascular Diseases / virology
China / epidemiology
Comorbidity
Convalescence
Coronavirus Infections / epidemiology
Coronavirus Infections / immunology*
Coronavirus Infections / pathology
Coronavirus Infections / virology
Cytokines / blood
Diabetes Mellitus / epidemiology
Diabetes Mellitus / immunology*
Diabetes Mellitus / pathology
Diabetes Mellitus / virology
Female
Hospitalization
Humans
Immunity, Innate*
Killer Cells, Natural / immunology
Killer Cells, Natural / pathology
Killer Cells, Natural / virology
Lung Diseases / epidemiology
Lung Diseases / immunology*
Lung Diseases / pathology
Lung Diseases / virology
Lymphocyte Subsets / immunology
Lymphocyte Subsets / pathology
Lymphocyte Subsets / virology
Male
Middle Aged
Monocytes / immunology
Monocytes / pathology
Monocytes / virology
Neoplasms / epidemiology
Neoplasms / immunology*
Neoplasms / pathology
Neoplasms / virology
Neutrophils / immunology
Neutrophils / pathology
Neutrophils / virology
Pandemics
Patient Discharge
Pneumonia, Viral / epidemiology
Pneumonia, Viral / immunology*
Pneumonia, Viral / pathology
Pneumonia, Viral / virology
SARS-CoV-2
Time Factors
Viral Load / immunology

Substances

Antibodies, Viral
Cytokines