International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025
Persistent attenuation of lymphocyte subsets after mass SARS-CoV-2 infection.
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Jiang Zhengqi, Shan Tichao, Li Yucan, Han Fengjiao, Feng Baobao, Zhen Xiaohui, Ma Ji, Ni Heyu, Peng Jun, Xu Miao
Аннотация
OBJECTIVES: Growing evidence suggests that lymphocyte subsets are declined in COVID-19 patients, but it is unclear if these alterations persist after widespread exposure to SARS-CoV-2 or how long they last.
METHODS: We analyzed lymphocyte subset data from 40,537 patients across three phases: pre-COVID, mass infection, and post-COVID. The counts of lymphocyte subsets and CD4+/CD8+ ratios were compared using Mann-Whitney U test or Kruskal-Wallis H test. Monthly post-exposure data were compared with pre-exposure data to assess the persistence of impact on lymphocyte subsets by SARS-CoV-2, and subgroup analyses were performed in patients with cardiovascular disease.
RESULTS: During mass infection, T cells, CD4+T cells, CD8+T cells, NK cells, and B cells dropped significantly. Even 20 months post-infection, CD8+ T cells remained 9.9% below baseline. Baseline lymphocyte subsets differed significantly by sex and age. Immune recovery varied by age and sex, with older adults and males showing prolonged lymphopenia. In cardiovascular disease patients, T lymphocytes remained 72.9% below baseline for 20 months post-infection.
CONCLUSION: Our findings redefine SARS-CoV-2 infection as a condition of long-lasting immune compromise. The sustained subnormal lymphocytes-particularly in cardiovascular disease cohorts-highlight a key immunologic feature of long COVID and underscore the need for personalized care.
METHODS: We analyzed lymphocyte subset data from 40,537 patients across three phases: pre-COVID, mass infection, and post-COVID. The counts of lymphocyte subsets and CD4+/CD8+ ratios were compared using Mann-Whitney U test or Kruskal-Wallis H test. Monthly post-exposure data were compared with pre-exposure data to assess the persistence of impact on lymphocyte subsets by SARS-CoV-2, and subgroup analyses were performed in patients with cardiovascular disease.
RESULTS: During mass infection, T cells, CD4+T cells, CD8+T cells, NK cells, and B cells dropped significantly. Even 20 months post-infection, CD8+ T cells remained 9.9% below baseline. Baseline lymphocyte subsets differed significantly by sex and age. Immune recovery varied by age and sex, with older adults and males showing prolonged lymphopenia. In cardiovascular disease patients, T lymphocytes remained 72.9% below baseline for 20 months post-infection.
CONCLUSION: Our findings redefine SARS-CoV-2 infection as a condition of long-lasting immune compromise. The sustained subnormal lymphocytes-particularly in cardiovascular disease cohorts-highlight a key immunologic feature of long COVID and underscore the need for personalized care.