Decreased Counts of T Lymphocyte Subsets Predict Prognosis in SARS-CoV-2-Infected Pneumonia in Wuhan, China: A Retrospective Study

Background: The outbreak and the rampant spread of SARS-CoV-2-infected pneumonia (COVID-19) first identified in Wuhan, China, has infected thousands of patients and killed more than two thousand. We aimed to find indicators that could predict the progression of SARS-CoV-2 pneumonia. Methods: Medical history, clinical features, laboratory and radiological results were retrospectively reviewed from 112 patients with clinically diagnosed SARS-CoV-2 pneumonia in Renmin Hospital of Wuhan University from Jan 1 to Jan 31, 2020. Clinical outcomes were followed up to Feb 9, 2020. Findings: Based on their outcomes, we divided these patients into groups of remission, deterioration and death respectively, and analyzed the counts of lymphocyte and its subsets. A decreased combination of CD3+, CD4+ and CD8+ T lymphocyte counts was observed as the SARS-CoV-2 pneumonia progressed. Among them, the CD4+ T lymphocyte counts were reduced at the early stage, while CD8+ counts were decreased at advanced stage or end stage. Interpretation: We identified in our study of 112 hospitalized patients that CD3+, CD4+ and CD8+ T lymphocyte counts were useful markers to predict the clinical progression of SARS-CoV-2 pneumonia at different stages. Considering the large number of patients with severe pneumonia, and the urgency of this ongoing global public health emergency, the counts of lymphocyte and its subsets from laboratory examinations could be easy and useful indicators for physicians to determine a timely and proper therapeutic strategy for patients and an early warning sign for predicting or reducing mortality in SARS-CoV-2-infected pneumonia. Funding Statement: This work was funded by the Research on the function of Comprehensive Hospitals in the Integrated Emergency Medicine System of Wuhan Megalopolis (ZC2010-11) and National Natural Science Foundation of China (81900364) Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: This study (WDRY2020-K044) was approved by the Ethics Committee of Renmin Hospital of Wuhan University and written informed consent was waived by the same committee.