urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.25.4.35MVELAPurmj-2285Research ArticleОригинальные статьи | Original articlesOriginal articlesПричины лимфопении у пациентов, умерших от COVID-19Causes of Lymphopenia in Patients Died from COVID-19https://orcid.org/0000-0001-9851-2386ЕвдокимоваА. Э.EvdokimovaA. E.

Арина Эдуардовна Евдокимова – аспирант кафедры детских инфекций

Казань

Arina E. Evdokimova – Postgraduate Student of the Department of Children’s Infections Diseases

Kazan

https://orcid.org/0000-0002-5279-2623РагиновИ. С.RaginovI. S.

Иван Сергеевич Рагинов – доктор медицинских наук, доцент кафедры общей патологии; заведующий патологоанатомическим отделением; профессор кафедры профилактической медицины, институт фундаментальной медицины и биологии

Казань

Ivan S. Raginov Doctor of Sciences (Medicine), Associate Professor of the Department of General Pathology; Head of the Pathological Anatomy Department; Professor of the Department of Preventive Medicine, Institute of Fundamental Medicine and Biology

Kazan

https://orcid.org/0000-0002-9013-4402ХаертыновХ. С.KhaertynovKh. S.

Халит Саубанович Хаертынов – доктор медицинских наук, доцент кафедры детских инфекций

Казань

Khalit S. Khaertynov – Doctor of Sciences (Medicine), Associate Professor of the Department of Children’s Infections Diseases

Kazan

khalit65@yandex.ruhttps://orcid.org/0000-0003-1050-9081АнохинВ. А.AnokhinV. A.

Владимир Алексеевич Анохин – доктор медицинских наук, профессор, заведующий кафедрой детских инфекций

Казань

Vladimir A. Anokhin – Doctor of Sciences (Medicine), Professor, Head of the Department of Children’s Infections Diseases

Kazan

https://orcid.org/0009-0008-7450-9893ОвчинниковаА. Г.OvchinnikovaA. G.

Амина Гаязовна Овчинникова – кандидат медицинских наук, доцент кафедры фармакологии

Казань

Amina G. Ovchinnikova – Candidate of Sciences (Medicine), Associate Professor of the Department of Pharmacology

Kazan

Казанский государственный медицинский университетРоссияKazan State Medical UniversityRussian FederationКазанский государственный медицинский университет; Республиканская клиническая больница Министерства здравоохранения Республики Татарстан; Казанский федеральный университетРоссияKazan State Medical University; Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; Kazan Federal UniversityRussian Federation20261808202625435–48Copyright © Евдокимова А.Э., Рагинов И.С., Хаертынов Х.С., Анохин В.А., Овчинникова А.Г., 20262026Евдокимова А.Э., Рагинов И.С., Хаертынов Х.С., Анохин В.А., Овчинникова А.Г.Evdokimova A.E., Raginov I.S., Khaertynov K.S., Anokhin V.A., Ovchinnikova A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/2285Введение 

Введение . Одним из проявлений тяжелого течения и неблагоприятного прогноза коронавирусной инфекции COVID-19 является лимфопения. Для установления причин ее развития представляется актуальным проведение исследования количества лимфоцитов в тканях легких и селезенки у пациентов, умерших от COVID-19.

Цель исследования провести сравнительный анализ количества субпопуляций лимфоцитов в легочной ткани и селезенке у пациентов с COVID-19.

Материал и методы 

Материал и методы . Проведено исследование аутопсийного материала, полученного от 17 пациентов, умерших от COVID-19. Группу сравнения составили 11 пациентов, погибших по иным причинам, не связанным с инфекционными заболеваниями. Проведено определение в легочной ткани и селезенке количества субпопуляций лимфоцитов CD3+, CD4+, CD8+ и CD20+.

Результаты 

Результаты . В легочной ткани пациентов с COVID-19 выявлено увеличение числа всех исследованных субпопуляций лимфоцитов. Наиболее выраженным было увеличение лимфоцитов CD4+ и CD8+, средние значения которых были выше показателей группы сравнения в 561 и 174 раза, соответственно. В селезенке у больных с COVID-19 отмечалось снижение количества субпопуляций лимфоцитов. Максимальным было уменьшение пула лимфоцитов CD8+, среднее его значение у пациентов с COVID-19 было меньше по сравнению с группой сравнения в 2,8 раза. Число лимфоцитов CD4+ было меньше по сравнению с показателями группы сравнения на 55 %, лимфоцитов CD20+ в 1,8 раза. У пациентов с COVID-19 выявлено уменьшение площади белой пульпы селезенки: медиана показателя была в 1,6 раза меньше по сравнению с группой сравнения.

Заключение 

Заключение . У пациентов, умерших от тяжелых форм COVID-19, отмечается накопление лимфоцитов в легочной ткани и снижение их в селезенке. Выявленное снижение площади белой пульпы селезенки у пациентов с COVID-19, свидетельствует об угнетении лимфопоэза и развитии иммуносупрессии.

Introduction 

Introduction : Lymphopenia is one of the main laboratory signs of severe COVID-19 and a poor prognosis. The purpose of this study was to evaluate the content of lymphocyte subpopulations in lung tissue and spleen in patients who died from COVID-19.

Materials and methods 

Materials and methods . A study was conducted on autopsy material obtained from 17 patients who died from COVID-19. The control group consisted of 11 patients who died from other, non-infectious causes. The quantities of CD3+ lymphocytes and CD4+, CD8+, and CD20+ lymphocyte subpopulations were determined in lung tissue and spleen.

Results 

Results . An increase in the number of CD3+, CD4+, and CD8+ positive cells was found in the lungs of patients who died from COVID-19. CD4+ and CD8+ positive cells showed the most pronounced increase, with mean values 561 and 174 times higher than the control group, respectively. In the spleen of patients with COVID-19, a two-fold decrease in the number of CD3+ positive cells was observed compared to the control group. The most pronounced reduction was seen in CD8+ positive cells, whose mean value in COVID-19 patients was 2.8 times lower than in the control group. The median area of the splenic white pulp in patients with COVID-19 was 1.6 times smaller than in the control group.

Conclusion 

Conclusion . Patients who died from severe forms of COVID-19 exhibit an accumulation in lung tissue and a depletion in the spleen. The identified reduction in the area of the splenic white pulp in COVID-19 patients indicates the development of immunosuppression.

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The authors declare that there are no conflicts of interest present.