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Aberrant hyperactivation of cytotoxic T-cell as a potential determinant of COVID-19 severity

Cited 63 time in Web of Science Cited 62 time in Scopus

Kang, Chang Kyung; Han, Gi-Chan; Kim, Minji; Kim, Gwanghun; Shin, Hyun Mu; Song, Kyoung-Ho; Choe, Pyoeng Gyun; Park, Wan Beom; Kim, Eu Suk; Kim, Hong Bin; Kim, Nam-Joong; Kim, Hang-Rae; Oh, Myoung-don

Issue Date
Elsevier BV
International Journal of Infectious Diseases, Vol.97, pp.313-321
Objectives: We hypothesized that immune response may contribute to progression of coronavirus disease-19 (COVID-19) at the second week of illness. Therefore, we compared cell-mediated immune (CMI) responses between severe and mild COVID-19 cases. Methods: We examined peripheral blood mononuclear cells of laboratory-confirmed COVID-19 patients from their first and third weeks of illness. Severe pneumonia was defined as an oxygen saturation <= 93% at room air. Expressions of molecules related to T-cell activation and functions were analyzed by flow cytometry. Results: The population dynamics of T cells at the first week were not different between the two groups. However, total numbers of CD4(+) and CD8(+) T cells tended to be lower in the severe group at the third week of illness. Expressions of Ki-67, PD-1, perforin, and granzyme B in CD4(+) or CD8(+) T cells were significantly higher in the severe group than in the mild group at the third week. In contrast to the mild group, the levels of their expression did not decrease in the severe group. Conclusions: Severe COVID-19 had a higher degree of proliferation, activation, and cytotoxicity of T-cells at the late phase of illness without cytotoxic T-cell contraction, which might contribute to the development of severe COVID-19. (c) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (
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  • College of Medicine
  • Department of Medicine
Research Area Immunology, Infectious Diseases, Vaccination, 감염병, 바이러스질환, 예방접종


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