Overall reduced lymphocyte subsets worsening disease severity and prognosis in COVID-19 severe cases with diabetes mellitus in Chengdu, China
BackgroundIn early December 2019 the outbreak of coronavirus disease 2019 (COVID-19) is widespread from Wuhan throughout China and the world.MethodsDemographic, clinical data of 95 confirmed cases with COVID-19 on admission at the Public and Health ClinicCentre of Chengdu from January 16 to March 16, 2020, were collected and analyzed. The data ofperipheral lymphocyte and subsetswere compared between severe and non-severe patients with or without diabetes mellitus (DM), and its relationship to
... s relationship to the disease severity, the viral negative conversion time, and the prognosis were analyzed.ResultsIn this COVID-19cohort the prevalence of DM was 20%. Patients with DM had significantly higher severe rate and worseprognosis than those without DM, the difference was significant(severe rate ,cured, unhealed and death in DM and non-DM groups:61.11%vs.25.00%,26.32%,68.42%,5.26%vs.71.05%,26.32%,2.68%,х2=2.940,3.394,P=0.003,0.001,respectively),simultaneously the prevalence of DM in severe cases was higher than that in non-severe group,the obvarious difference was found(36.67% vs.12.31%,х2=2.940,P=0.003). Severe cases with DM tended to have the lowest lymphocytes count levels and percentage values,as well as the lowest T cells count levels, helper T cells count levels, suppressor T cells count levels and B(CD19+) count levelscompared with those severe cases without DM and non-severe cases with or without DM. The important influencing factorswere that age,DM, lymphocyte percentage values and helper T cells percentage values for the disease severity, lymphocyte percentage values andB(CD19+) cell percentage values for the viral negative conversion time, and age, the disease severity and the viral negative conversion time for the prognosis.ConclusionsThe COVID-19 severe cases with DMhad the lowest lymphocytes count levels, especially T lymphocytescount levels and B lymphocytes count levels. Overall decreased lymphocytes subsets and DM maybe worsen prognosis by worseningthe disease severity and prolonging the viral negative conversion time.Combinationimmunomodulatory therapy based on comprehensive treatmentmight improveprognosisof the COVID-19 severe cases with DM.