期刊
SCANDINAVIAN JOURNAL OF IMMUNOLOGY
卷 93, 期 2, 页码 -出版社
WILEY
DOI: 10.1111/sji.12967
关键词
COVID-19; lymphocytes; lymphopenia; SARS-CoV-2
类别
Lymphopenia, a major immunological abnormality in COVID-19 patients, is strongly associated with mortality rate. The reduction of lymphocytes may be caused by both SARS-CoV-2- and immune-mediated mechanisms, as well as metabolic and biochemical changes in patients. Preventing lymphopenia could potentially help improve patient outcomes.
The lymphopenia as a major immunological abnormality occurs in the majority of severe COVID-19 patients, which is strongly associated with mortality rate. A low proportion of lymphocytes may express the main receptor for SARS-CoV-2, called angiotensin-converting enzyme 2 (ACE2). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can also use ACE2-independent pathways to enter lymphocytes. Both SARS-CoV-2- and immune-mediated mechanisms may contribute to the occurrence of lymphopenia through influencing the lymphocyte production, survival or tissue re-distribution. The metabolic and biochemical changes can also affect the production and survival of lymphocytes in COVID-19 patients. Lymphopenia can cause general immunosuppression and promote cytokine storm, both of them play an important role in the viral persistence, viral replication, multi-organ failure and eventually death. Here, a comprehensive view concerning the possible mechanisms that may lead to the lymphocyte reduction in COVID-19 patients is provided, while highlighting the potential intervention approaches to prevent lymphopenia.
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