Lymphocyte subsets with the lowest decline at baselineand the slow lowest rise during recovery in COVID-19 critical illnesspatients with diabetes mellitus

Liu, Dafeng; Lan, Lijuan; Luo, Dongxia; Zhao, Bennan; Wei, Guo; He, Yinsheng; Zhang, Renqing; Liu, Yalin

Abstract Background Host dysregulation of immune response was highly involved in thepathological process of Coronavirus disease 2019 (COVID-19), especially COVID-19severe cases with DM. Aim In this study we aimed at the dynamic changeof peripheral lymphocyte and subsets during COVID-19covery. Methods The peripheral lymphocyte and subsetsof 95 confirmed cases with COVID-19from baseline to four weeks were compared between critical illness and non-critical illness cases with or without DM. Results The dynamic characteristics oflymphocyteand subsets in COVID-19patients was that it reduced significantly at one week, rapidlyelevated to the peak at two weeks after onset, then gradually declined during recovery. The COVID-19 critical illnesspatients with DM had the lowest decline at one week and the slow lowest rise at two weeks after onset, while COVID-19 non-critical illnesspatients with DMhad therapid highest rise at two weeks after onset, both of them had similar lymphocyte and subsets at five weeks after onset and lower than those patients without DM. Conclusions These findings provide a reference for cliniciansthat for COVID-19patients withDM and the lowest decline of lymphocyte and subsets, immunomodulatory therapy as soon as possiblemight avoid or slow downdisease progression; moreover for COVID-19 critical illness patients with or without DM and non-critical illnesspatients with DM, continuous immunomodulatory therapy in later stages of disease might speed up virus clearance, shorten hospital stay, improve disease prognosisin COVID-19 critical illness patientswith DM.