This studyinvestigated how the immune system changes were related to disease severity inCOVID-19 patients. Moreover, other data indicated thatthe levels of these cytokines were reduced during the disease recovery. PBMCs were isolated from healthy subjects and COVID-19patients and then stained with different monoclonal antibodies. To determine the situations of humoral and cellular immunity in patients withCOVID-19, the frequencies of Th1, Th2, Th17, Treg, activated CD4+T cells,activated CD8+ T cells, exhausted CD4+ T cells, exhausted CD8+ T cells, and Bcells in COVID-19 patients were investigated after 1 and 10 days of initiationof therapeutic methods. Correlations of lymphocyte numbers with the value of ESR and numbers ofTh2 cells and monocytes in COVID-19 patients. Some patients hadfatigue, mild shortness of breath, myalgia, loss of weight, smell, and taste inthe late recovery stage.
To determine cytokine profiles in COVID-19 patients, the plasma samples wereobtained from whole blood (5 ml) of participants and the levels of IL-1α, IL-1β,TNF-α, IL-6, TGF-β1, and IL-10 cytokines were measured using an Enzyme-linkedimmunoasorbent assay (ELISA) kit (Karmania Pars Gene, Iran) according themanufacturer’s instructions. Thepatients suffered from clinical signs and symptoms of COVID-19 at least 3–5 daysbefore going to a COVID-19 center to start therapeutic approaches. Some studies havereported that COVID-19 patients had the reduced number of Tregs in peripheral blood.22 It is not the first time that coronavirusfamily causes a severe respiratory disease. SMART Takes is a monthly newsletter filled with content about self-empowered, practical, and evidence-informed recovery.
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- Thepatients suffered from clinical signs and symptoms of COVID-19 at least 3–5 daysbefore going to a COVID-19 center to start therapeutic approaches.
- Other results of the currentstudy revealed that the percentage of another subset of NK cells(CD56highCD16+/− NK cells) was significantly increased atthe first day of recovery.
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The number of lymphocytes in peripheral blood of COVID-19 patients in the earlyand late stages of recovery and healthy subjects were assessed by an automatedcell counter system UF-100® (Sysmex, Kobe, Japan) within 3 h aftercollecting blood samples. The results of this study provide evidence to show that COVID-19 patients, who needto hospitalization, had some changes in the immune system during the diseaserecovery to improve and regulate immune responses. Thesefindings were consistent with other reports indicating the number of CD8+ T cellswas markedly decreased and its function was exhausted in COVID-19 patients.29 In contrast with the percentage of activated CD4+ T cell which was increasedin the early stage of recovery, the activated CD8+ T cell had the reduced frequency;however its number was significantly increased in the late stage of recovery, unlikeactivated CD4+ T cell number. The results indicated thatpatients had the reduced number of lymphocyte in comparison with healthy subjects.In line with this finding, Qin et al. declared that patients with COVID-19 had areduction in T cell number accompanied by the severity of the disease. We observed that COVID-19patients had significantly higher percentage of monocytes in the early stage ofrecovery than those in the late stage of recovery and healthy subjects.
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- In this study, the mean ± SD of age of patients was 67.8 ± 15.18, while it was66.01 ± 7.11 in healthy subjects.
- Antibodies used for determing the changes of the immune system ofCOVID-19 patients by flow cytometry.
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- The isolated cells were washed twice with phosphate buffered saline(PBS) at 300 × g for 10 min.
CD56highCD16+/− NK cells aredescribed by NKG2A, low level of perforin, and are primarily characterized bycytokine production.16,30,31 Therefore, it is likely that the changes in the frequencies oftwo subsets of NK cells during the disease recovery are protective mechanisms toeliminate the SARS-COV2 and thereby reducing inflammation occurred in the earlystages of disease. Our data revealed that the percentages of Th1, Th2, andTh17 cells were significantly lower in patients than healthy control (Figure 3(a)–(c) and (j)–(l), P Figure 3(d)–(h) and (m)–(q), P Figure 3(f), (h), (o), and (q), P Figure3(d), (e),(g), (m), (n), and (p)). The number of CD56low CD16+ NK cells in patients wassignificantly increased compared to healthy subjects. To determine the percentages of activated T cells, exhausted T cells, Th1 cells,Th2 cells, Th17 cells, Tregs, B cells, NK cells, and monocytes in peripheralblood of COVID-19 patients (the first day and 10 days of initiation oftherapeutic approaches) and healthy subjects, PBMCs were stained with differentmonoclonal antibodies or matched to isotype control IgG for 30 min at4○C. These changes may play afundamental role in reducing disease severity through regulating cytokineproductions involved in the inflammation and functions of various immune cells.Nevertheless, larger and more multicenter studies are needed to validate theseconclusions. A limitation of the study was the lack of determinationof immune system differences between alive and dead patients with COVID-19 during arecovery period.
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In disagreement with other reports showing increasedfrequency of B cells in the late stage of recovery,17 we observed that the percentage of this cell was decreased followingrecovery. Moreinterestingly, the percentages of exhausted CD4+ T cells and exhausted CD8+ T cellswere higher in the early stage of recovery than the late stage of recovery. Thisobservation was in contrast with previous study showing severe cases of COVID-19tend to have lower percentages of monocytes.24 This discrepancy may be attributed to disease stage which patients wereevaluated.
Moreover, Qinet al. indicated that suppressor and helper T cell percentages were lower inpatients than normal group. In the next step, the adaptive immune system of COVID-19 subjects was studied after 1and 10 days of initiation of therapeutic methods. In an attempt to discover the frequency of other cells of innateimmunity, the number of monocytes was also assessed. As shown inFigure 4(a)–(d),statistically significant reduction in the levels of pro-inflammatory cytokines(IL-1α, IL-1β, IL-6, and TNF-α) in patients were observed during a recovery,with the exception of IL-1β level (P Figure 4(e),P Figure 4(f)). Having considered that severe COVID-19 is largely related to a cytokine storm,cytokine profiles of COVID patients were assessed during a recovery.
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The CD3+ cell population was also determined using the gating oflymphocyte population and was then used to measure the percentages of B cells(CD3− CD19+ CD22+ cells), exhausted CD4+ T cells (CD3+ CD4+ PD-1+ cells),exhausted CD8+ T cells (CD3+ CD8+ PD-1+ cells), CD56lowCD16+ NK cells (CD3− CD56lowCD16+ cells), and CD56high CD16+/− NK cells(CD3−CD56high CD16+/− cells). Afterwards, the lymphocyte population was gatedto assess the frequencies of the CD4+ cells which were used to determine thepercentages of Th1 cells (CD4+ T-bet+ IFN-γ+ cells), Th2 cells (CD4+ IL-4+GATA3+ cells), Th17 cells (CD4+ IL-17α+ RORγt+ cells), Tregs (CD4+CD127low FoxP3+ cells), and activated CD4+ T cells (CD4+ CD25+CD69+ cells). At the first day (the early recovery stage) and 10 days of initiation oftherapeutic methods (the late recovery stage), heparinized blood samples (5 ml)were obtained from patients. All patients had pulmonary involvement and were not on treatment withdrugs influencing the immune system and antibodies production (i.e. steroids,sulfasalazine, phenytoin, and antimalarial drugs) prior to study initiation.
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I have never been hacked, never uploaded a video, never left a comment, never received a warning, and never violated any guidelines. I should add that I am attempting to log in from a “familiar device” — the same computer I used to create the account in the first place. I cant even request a “resolution” from Google because one must be logged in to the account to even make the request.It is very important that I be able to log back into the account, and there’s absolutely no reason why I should be frozen out. Twice now II have waited a full 7+ days between log revery play login in attempts, so it no longer would think there was “unusual activity,” but waiting a week didn’t help either time.Why is this happening and how can I get back into my own account?