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. 2020 Aug:217:108486.
doi: 10.1016/j.clim.2020.108486. Epub 2020 May 29.

Selective CD8 cell reduction by SARS-CoV-2 is associated with a worse prognosis and systemic inflammation in COVID-19 patients

J M Urra  1 , C M Cabrera  2 , L Porras  3 , I Ródenas  4
Affiliations

Selective CD8 cell reduction by SARS-CoV-2 is associated with a worse prognosis and systemic inflammation in COVID-19 patients

J M Urra et al. Clin Immunol. 2020 Aug.

Abstract

The lymphopenia exhibited in patients with COVID-19 has been associated with a worse prognosis in the development of the disease. To understand the factors associated with a worse evolution of COVID-19, we analyzed comorbidities, indicators of inflammation such as CRP and the ratio of neutrophils/lymphocytes, as well as the count of blood cells with T-lymphocyte subtypes in 172 hospitalized patients with COVID-19 pneumonia. Patients were grouped according to their needs for mechanical ventilation (ICU care) or not. Within the comorbidities studied, obesity was the only associated with greater severity and ICU admission. Both the percentage and the absolute number of neutrophils were higher in patients needing ICU care than non-ICU patients, whereas absolute lymphocyte count, and especially the percentage of lymphocytes, presented a deep decline in critical patients. There was no difference between the two groups of patients for CD4 T-lymphocytes, neither in percentage of lymphocyte nor in absolute number, however for CD8 T-cells the differences were significant for both parameters which were in decline in ICU patients. There was a firm correlation between the highest values of inflammation indicators with the decrease in percentage of CD8 T-lymphocytes. This effect was not seen with CD4 cells. Obesity together with lymphopenia, especially whether preferentially affects to CD8 T- lymphocytes, are factors that can predict a poor prognosis in patients with COVID-19.

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Conflict of interest statement

Declaration of Competing Interest The authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Mean values ± standard deviation, with maximum and minimum in the percentages of CD3, CD4 and CD8 lymphocytes in patients with or without ICU care.
Fig. 2
Fig. 2
Odds ratios (ORs) with the confidence intervals (CIs) at 95% in a univariate regression analysis for T-lymphocyte subpopulations and indicators of inflammation C-reactive protein (CRP) and Neutrophil/ Lymphocyte ratio (NLR) depending on the ICU requirements in patients with COVID-19.
Fig. 3
Fig. 3
Linear regression between lymphocyte subpopulations CD3, CD4 and CD8 and the inflammation indicators C-reactive protein (CRP) and Neutrophil/ Lymphocyte ratio (NLR).
See this image and copyright information in PMC

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