关键词: 新型冠状病毒, 肺部感染, 淋巴细胞亚群, 细胞因子

Abstract:

Objective To analyze the characteristics of peripheral blood lymphocyte subsets and cytokinesin patients with novel coronavirus（SARS⁃CoV⁃2）infection with normal CT at baseline，and to explore their rela⁃tionship to clinical outcome. Methods 48 patients of SARS⁃CoV⁃2 infection with normal CT at baseline admittedto Guangzhou eighth people′s Hospital from March to April 2020 were analyzed retrospectively. According to theirclinical outcome，the patients were divided into two groups：new diagnosis of pneumonia group and non⁃pneumoniagroup. Nonparametric rank sum test and Fisher exact probability method were used to analyze the differencebetween the two groups. Cox regression analysis was used to find out risk factors of new diagnosis of pneumonia.ROC curve analysis was used to predict the value of new diagnosis of pneumonia. Results 24 cases（15 males and9 females）were included in both new diagnosis of pneumonia group and non⁃pneumonia group. The average age ofnew diagnosis of pneumonia group and t non⁃pneumonia group was（38.25 ± 10.65）and（38.12 ± 10.89）years，respectively，and there was no significant difference between the two groups（P > 0.05）. Compared with non⁃pneu⁃monia group，the total number of T lymphocytes，CD4+ T lymphocytes，CD8+ T lymphocytes and B lymphocytes inperipheral blood of patients in new diagnosis of pneumonia group were lower and IL⁃6 were higher（Z = -2.588，-2.563，-2.746，-1.981 and -2.752，all P < 0 05）. But there was no significant difference in CD4+/CD8+ ratio，IL⁃2，IL⁃4，IL⁃10，TNF⁃α and IFN⁃γ pneumonia（OR = 5.500，95%CI：1.219～24.813，P = 0.027）. The area under ROC curve of IL⁃6 was 0.751，cutoffvalue was 3.39 pg/mL，sensitivity and specificity were 80.0% and 71.4%，positive predictive value and negative pre⁃dictive valuewere73.7%and78.1%，respectively.Conclusion In the patients with new diagnosis of coronavirus pneu⁃monia，T lymphocyte subsets and B lymphocytes are lower and IL⁃6 is higher. IL⁃6 has moderate predictive valuefor new diagnosis of coronavirus pneumonia. IL⁃6 may be the initiator of cytokine storm.

Key words: SARS?CoV?2, pneumonia, lymphocyte subsets, cytokine