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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Virus and Host
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1488607

Persistent CD19 + B Cell Lymphopenia in Critically Ill COVID-19 Patients 50 Days After Symptom Onset

Provisionally accepted
Hui An Hui An Ting Li Ting Li Xinyue Zhang Xinyue Zhang Hao Hu Hao Hu Chen Zhang Chen Zhang Yongyu Wang Yongyu Wang Shengwei Jin Shengwei Jin Ming Li Ming Li *
  • Wenzhou Medical University, Wenzhou, China

The final, formatted version of the article will be published soon.

    Long COVID (LC) poses a persistent challenge in clinical practice due to limited understanding of its etiology. LC is hypothesized to stem from aberrant immune responses in COVID-19. Vaccinations, which boost immune cells to restore function, could help ease LC symptoms. To exclude the impact of vaccination, we examined the immune cell profiles of recovering COVID-19 patients before vaccines were available. White blood cell differentials were monitored in ninety-two healthy unvaccinated controls. Seventy-six unvaccinated COVID-19 patients were monitored upon admission and on the 50th day post-symptom onset (DPSO50). Peripheral lymphocyte subsets were analyzed using flow cytometry.Mild cases showed no significant changes in lymphocyte counts or subsets from admission to DPSO50. By DPSO50, severe and critical cases showed almost complete recovery from lymphopenia, with critical cases having CD19 + B-cell counts approximately 45% lower than mild group. Severe and critical cases showed reduced B-cell frequencies, with critical cases displaying around 48% higher natural killer (NK) cell counts. In mild cases, NK cell counts negatively correlated with B-cell counts (r=-0.528, p=0.02).Additionally, critical cases showed positive correlations between NK cell counts and CD4 + T-cell counts (r=0.83, p<0.01), and between NK cell counts and CD8 + T-cell counts (r=0.74, p<0.01). Severe cases demonstrated decreased counts of CD4 + CD25 + CD127 low FoxP3 + regulatory T-cells (Tregs), which positively correlated with B-cell counts (r=0.37, p<0.05). Our findings indicate that aberrant immune cell profiles in COVID-19 patients change dynamically during recovery, depending on disease severity.This study suggests that convalescent patients from critical COVID-19 may experience long-lasting Bcell lymphopenia.

    Keywords: COVID-19, Long Covid, Convalescence, aberrant immune-cell profiles ， B cell lymphopenia, regulatory T cells

    Received: 30 Aug 2024; Accepted: 08 Nov 2024.

    Copyright: © 2024 An, Li, Zhang, Hu, Zhang, Wang, Jin and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ming Li, Wenzhou Medical University, Wenzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.