Clinical outcome prediction in COVID-19 patients by lymphocyte subsets analysis and monocytes’ iTNF-α expression

Gabriele Madonna, Silvia Sale, Mariaelena Capone, Chiara De Falco, Valentina Santocchio, Tiziana Di Matola, Giuseppe Fiorentino, Caterina Pirozzi, Anna D’antonio, Rocco Sabatino, Lidia Atripaldi, Umberto Atripaldi, Marcello Raffone, Marcello Curvietto, Antonio Maria Grimaldi, Vito Vanella, Lucia Festino, Luigi Scarpato, Marco Palla, Michela SpatarellaFrancesco Perna, Pellegrino Cerino, Gerardo Botti, Roberto Parrella, Vincenzo Montesarchio, Paolo Antonio Ascierto, Luigi Atripaldi

Research output: Contribution to journalArticlepeer-review


In December 2019, a novel coronavirus, “SARS-CoV-2”, was recognized as the cause of coronavirus disease 2019 (COVID-19). Several studies have explored the changes and the role of inflammatory cells and cytokines in the immunopathogenesis of the disease, but until today, the results have been controversial. Based on these premises, we conducted a retrospective assessment of monocyte intracellular TNF-α expression (iTNF-α) and on the frequencies of lymphocyte sub-populations in twenty-five patients with moderate/severe COVID-19. We found lymphopenia in all COVID-19 infected subjects compared to healthy subjects. On initial observation, in patients with favorable outcomes, we detected a high absolute eosinophil count and a high CD4+/CD8+ T lymphocytes ratio, while in the Exitus Group, we observed high neutrophil and CD8+ T lymphocyte counts. During infection, in patients with favorable outcomes, we observed a rise in the lymphocyte count, in the monocyte and in Treg lymphocyte counts, and in the CD4+ and in CD8+ T lymphocytes count but a reduction in the CD4+/CD8+ T lymphocyte ratio. Instead, in the Exitus Group, we observed a reduction in the Treg lymphocyte counts and a decrease in iTNF-α expression. Our preliminary findings point to a modulation of the different cellular mediators of the immune system, which probably play a key role in the outcomes of COVID-19.

Original languageEnglish
Article number735
Issue number8
Publication statusPublished - Aug 2021


  • COVID-19
  • Eosinophils
  • ITNF-α
  • Lymphocytes
  • Monocytes
  • Neutrophils
  • SARS-CoV-2
  • Tregs

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Agricultural and Biological Sciences(all)


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