Increased CD4/CD8 T-cell ratio : A risk factor for mortality in patients with coronavirus disease 2019

Abstract

Introduction: Although CD4 and CD8 T-cells are the main subset of T-lymphocytes, their roles in COVID-19 infection and severity remain unclear. This study aimed to determine the role of increased CD4/CD8 T-cells ratio as a risk factor for cases of 28-days in-hospital mortality in COVID-19 patients.

Materials and methods: This study employed a prospective cohort design. Inclusion criteria were confirmed COVID-19 cases with a positive polymerase chain reaction report. CD4 and CD8 T-cells absolute counts were measured by flow cytometry. The CD4/CD8 ratio was calculated by dividing the absolute count of CD4 by that of CD8 T-cells.

Results: A total of 85 subjects were followed for 28 days. The mean age of the subjects was 52.64 years, and majority of them were females (51.8%). Twenty-eight (32.9%) subjects died within 28 days of follow-up. Receiver operating characteristics analysis obtained an area under curve of 0.68 with the cut-off value 1.26 with p = 0.005. Kaplan-Meier's analysis obtained Hazard Ratio 2.91 (95%CI 1.377-6.161; p = 0.0052).

Conclusion: Subjects with an increase in CD4/CD8 T-cells ratio >1.26 had a 2.91-times risk of 28 days in-hospital mortality.