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J Clin Med . NKG2A Expression among CD8 Cells Is Associated with COVID-19 Progression in Hypertensive Patients: Insights from the BRACE CORONA Rando

tetano

Editor, Senior Moderator
J Clin Med


. 2022 Jun 27;11(13):3713.
doi: 10.3390/jcm11133713.
NKG2A Expression among CD8 Cells Is Associated with COVID-19 Progression in Hypertensive Patients: Insights from the BRACE CORONA Randomized Trial


Renata Moll-Bernardes[SUP] 1 [/SUP], Sérgio C Fortier[SUP] 1 2 [/SUP], Andréa S Sousa[SUP] 1 3 [/SUP], Renato D Lopes[SUP] 1 4 5 [/SUP], Narendra Vera[SUP] 6 [/SUP], Luciana Conde[SUP] 6 [/SUP], André Feldman[SUP] 1 7 [/SUP], Guilherme Arruda[SUP] 1 8 [/SUP], Mauro Cabral-Castro[SUP] 9 [/SUP], Denílson C Albuquerque[SUP] 1 10 [/SUP], Thiago C Paula[SUP] 1 11 [/SUP], Thyago Furquim[SUP] 1 12 [/SUP], Vitor A Loures[SUP] 1 7 [/SUP], Karla Giusti[SUP] 1 13 [/SUP], Nathália Oliveira[SUP] 1 13 [/SUP], Ariane Macedo[SUP] 1 11 14 [/SUP], Pedro Barros E Silva[SUP] 5 [/SUP], Fábio De Luca[SUP] 1 15 [/SUP], Marisol Kotsugai[SUP] 1 15 [/SUP], Rafael Domiciano[SUP] 1 7 [/SUP], Flávia A Silva[SUP] 1 2 [/SUP], Mayara F Santos[SUP] 1 [/SUP], Olga F Souza[SUP] 1 16 [/SUP], Fernando A Bozza[SUP] 1 3 [/SUP], Ronir R Luiz[SUP] 1 17 [/SUP], Emiliano Medei[SUP] 1 6 18 [/SUP]



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Free article

Abstract

Cardiovascular comorbidities and immune-response dysregulation are associated with COVID-19 severity. We aimed to explore the key immune cell profile and understand its association with disease progression in 156 patients with hypertension that were hospitalized due to COVID-19. The primary outcome was progression to severe disease. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and immune cell subsets associated with the primary outcome. Obesity; diabetes; oxygen saturation; lung involvement on computed tomography (CT) examination; the C-reactive protein concentration; total lymphocyte count; proportions of CD4+ and CD8+ T cells; CD4/CD8 ratio; CD8+ HLA-DR MFI; and CD8+ NKG2A MFI on admission were all associated with progression to severe COVID-19. This study demonstrated that increased CD8+ NKG2A MFI at hospital admission, in combination with some clinical variables, is associated with a high risk of COVID-19 progression in hypertensive patients. These findings reinforce the hypothesis of the functional exhaustion of T cells with the increased expression of NKG2A in patients with severe COVID-19, elucidating how severe acute respiratory syndrome coronavirus 2 infection may break down the innate antiviral immune response at an early stage of the disease, with future potential therapeutic implications.

Keywords: COVID-19; HLA-DR; NKG2A; T cell; hypertension; immune response.
 
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