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The Role of Cytokine Profile and Lymphocyte Subsets in the Severity of Coronavirus Disease 2019 (Covid-19): A Systematic Review and Meta-Analysis Publisher Pubmed



Akbari H1, 2 ; Tabrizi R3 ; Lankarani KB3 ; Aria H4, 5 ; Vakili S6 ; Asadian F7 ; Noroozi S8 ; Keshavarz P9 ; Faramarz S2
Authors
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Authors Affiliations
  1. 1. Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
  2. 2. Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
  3. 3. Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4. Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Bioinformatics and Computational Biology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Biochemistry Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
  7. 7. Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
  8. 8. Department of Biochemistry, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
  9. 9. Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Source: Life Sciences Published:2020


Abstract

Aims: This study aimed to make a comparison between the clinical laboratory-related factors, complete blood count (CBC) indices, cytokines, and lymphocyte subsets in order to distinguish severe coronavirus disease 2019 (COVID-19) cases from the non-severe ones. Materials and methods: Relevant studies were searched in PubMed, Embase, Scopus, and Web of Science databases until March 31, 2020. Cochrane's Q test and the I2 statistic were used to determine heterogeneity. We used the random-effect models to pool the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Key findings: Out of a total of 8557 initial records, 44 articles (50 studies) with 7865 patients (ranging from 13 to 1582), were included. Our meta-analyses with random-effect models showed a significant decrease in lymphocytes, monocyte, CD4+ T cells, CD8+ T cells, CD3 cells, CD19 cells, and natural killer (NK) cells and an increase in the white blood cell (WBC), neutrophils, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP)/hs-CRP, erythrocyte sedimentation rate (ESR), ferritin, procalcitonin (PCT), and serum amyloid A (SAA), interleukin-2 (IL-2), IL-2R, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (INF-γ) in the severe group compared to the non-severe group. However, no significant differences were found in IL-1β, IL-17, and CD4/CD8 T cell ratio between the two groups. Significance: Decrease in total lymphocytes and lymphocyte subsets as well as the elevation of CRP, ESR, SAA, PCT, ferritin, and cytokines, but not IL-1β and IL-17, were closely associated with COVID-19 severity, implying reliable indicators of severe COVID-19. © 2020 Elsevier Inc.
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