4.7 Article

Inflammatory Profiles and Clinical Features of Coronavirus 2019 Survivors 3 Months After Discharge in Wuhan, China

Journal

JOURNAL OF INFECTIOUS DISEASES
Volume 224, Issue 9, Pages 1473-1488

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab181

Keywords

Recovered COVID-19 patients; 3 months after discharge; cytokine profiles; immune cells; clinical features

Funding

  1. National Natural Science Special Foundation of China [82041018]
  2. National Major Science and Technology Projects of China [2019ZX09301001]
  3. Ministry of Science and Technology of the People's Republic of China [2020YFC0844300]

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The study found that inflammation and vascular injury persisted in COVID-19 patients 3 months after discharge, and were closely correlated with abnormal clinical features, especially in severe patients. Immune cell levels had returned to normal levels and were not significantly correlated with abnormal clinical features.
Background. Postdischarge immunity and its correlation with clinical features among patients recovered from coronavirus disease 2019(COVID-19) are poorly described. This prospective cross-sectional study explored the inflammatory profiles and clinical recovery of patients with COVID-19 at 3 months after hospital discharge. Methods. Patients with COVID-19 discharged from 4 hospitals in Wuhan, recovered asymptomatic patients (APs) from an isolation hotel, and uninfected healthy controls (HCs) were recruited. Viral nucleic acid and antibody detection, laboratory examination, computed tomography, pulmonary function assessment, multiplex cytokine assay, and flow cytometry were performed. Results. The72 age-, sex- and body mass index-matched participants included 19 patients with severe/critical COVID-19 (SPs), 20 patients with mild/moderate COVID-19 (MPs), 16 APs, and 17 HCs. At 3 months after discharge, levels of proinflammatory cytokines and factors related to vascular injury/repair in patients recovered from COVID-19 had not returned to those of the HCs, especially among recovered SPs compared with recovered MPs and APs. These cytokines were significantly correlated with impaired pulmonary function and chest computed tomographic abnormalities. However, levels of immune cells had returned to nearly normal levels and were not significantly correlated with abnormal clinical features. Conclusion. Vascular injury, inflammation, and chemotaxis persisted in patients with COVID-19 and were correlated with abnormal clinical features 3 months after discharge, especially in recovered SPs.

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