tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Jan 12;21(1):57.
doi: 10.1186/s12879-020-05741-w.
Clinical characteristics and predictive value of lower CD4 [SUP]+[/SUP] T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study
Xue-Song Wen[SUP] 1 [/SUP], Dan Jiang[SUP] 1 [/SUP], Lei Gao[SUP] 1 [/SUP], Jian-Zhong Zhou[SUP] 1 [/SUP], Jun Xiao[SUP] 2 [/SUP], Xiao-Cheng Cheng[SUP] 1 [/SUP], Bin He[SUP] 1 [/SUP], Yue Chen[SUP] 1 [/SUP], Peng Lei[SUP] 1 [/SUP], Xiao-Wei Tan[SUP] 1 [/SUP], Shu Qin[SUP] 1 [/SUP], Dong-Ying Zhang[SUP] 3 [/SUP]
Affiliations
Abstract
Background: In December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei, China. Moreover, it has become a global pandemic. This is of great value in describing the clinical symptoms of COVID-19 patients in detail and looking for markers which are significant to predict the prognosis of COVID-19 patients.
Methods: In this multicenter, retrospective study, 476 patients with COVID-19 were enrolled from a consecutive series. After screening, a total of 395 patients were included in this study. All-cause death was the primary endpoint. All patients were followed up from admission till discharge or death.
Results: The main symptoms observed in the study included fever on admission, cough, fatigue, and shortness of breath. The most common comorbidities were hypertension and diabetes mellitus. Patients with lower CD4[SUP]+[/SUP]T cell level were older and more often male compared to those with higher CD4[SUP]+[/SUP]T cell level. Reduced CD8[SUP]+[/SUP]T cell level was an indicator of the severity of COVID-19. Both decreased CD4[SUP]+[/SUP]T [HR:13.659; 95%CI: 3.235-57.671] and CD8[SUP]+[/SUP]T [HR: 10.883; 95%CI: 3.277-36.145] cell levels were associated with in-hospital death in COVID-19 patients, but only the decrease of CD4[SUP]+[/SUP]T cell level was an independent predictor of in-hospital death in COVID-19 patients.
Conclusions: Reductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe cases of COVID-19. It was the CD8[SUP]+[/SUP]T cell level, not the CD4[SUP]+[/SUP]T cell level, that reflected the severity of the patient's disease. Only reduced CD4[SUP]+[/SUP]T cell level was independently associated with increased in-hospital death in COVID-19 patients.
Trial registration: Prognostic Factors of Patients With COVID-19, NCT04292964 . Registered 03 March 2020. Retrospectively registered.
Keywords: CD4+T cells; COVID-19; In-hospital death; SARS-CoV-2.
. 2021 Jan 12;21(1):57.
doi: 10.1186/s12879-020-05741-w.
Clinical characteristics and predictive value of lower CD4 [SUP]+[/SUP] T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study
Xue-Song Wen[SUP] 1 [/SUP], Dan Jiang[SUP] 1 [/SUP], Lei Gao[SUP] 1 [/SUP], Jian-Zhong Zhou[SUP] 1 [/SUP], Jun Xiao[SUP] 2 [/SUP], Xiao-Cheng Cheng[SUP] 1 [/SUP], Bin He[SUP] 1 [/SUP], Yue Chen[SUP] 1 [/SUP], Peng Lei[SUP] 1 [/SUP], Xiao-Wei Tan[SUP] 1 [/SUP], Shu Qin[SUP] 1 [/SUP], Dong-Ying Zhang[SUP] 3 [/SUP]
Affiliations
- PMID: 33435865
- PMCID: PMC7803000
- DOI: 10.1186/s12879-020-05741-w
Abstract
Background: In December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei, China. Moreover, it has become a global pandemic. This is of great value in describing the clinical symptoms of COVID-19 patients in detail and looking for markers which are significant to predict the prognosis of COVID-19 patients.
Methods: In this multicenter, retrospective study, 476 patients with COVID-19 were enrolled from a consecutive series. After screening, a total of 395 patients were included in this study. All-cause death was the primary endpoint. All patients were followed up from admission till discharge or death.
Results: The main symptoms observed in the study included fever on admission, cough, fatigue, and shortness of breath. The most common comorbidities were hypertension and diabetes mellitus. Patients with lower CD4[SUP]+[/SUP]T cell level were older and more often male compared to those with higher CD4[SUP]+[/SUP]T cell level. Reduced CD8[SUP]+[/SUP]T cell level was an indicator of the severity of COVID-19. Both decreased CD4[SUP]+[/SUP]T [HR:13.659; 95%CI: 3.235-57.671] and CD8[SUP]+[/SUP]T [HR: 10.883; 95%CI: 3.277-36.145] cell levels were associated with in-hospital death in COVID-19 patients, but only the decrease of CD4[SUP]+[/SUP]T cell level was an independent predictor of in-hospital death in COVID-19 patients.
Conclusions: Reductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe cases of COVID-19. It was the CD8[SUP]+[/SUP]T cell level, not the CD4[SUP]+[/SUP]T cell level, that reflected the severity of the patient's disease. Only reduced CD4[SUP]+[/SUP]T cell level was independently associated with increased in-hospital death in COVID-19 patients.
Trial registration: Prognostic Factors of Patients With COVID-19, NCT04292964 . Registered 03 March 2020. Retrospectively registered.
Keywords: CD4+T cells; COVID-19; In-hospital death; SARS-CoV-2.