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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMC+Infect+Dis 2021 ; 21 (1): 57 Nephropedia Template TP
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Clinical characteristics and predictive value of lower CD4(+)T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study #MMPMID33435865
Wen XS; Jiang D; Gao L; Zhou JZ; Xiao J; Cheng XC; He B; Chen Y; Lei P; Tan XW; Qin S; Zhang DY
BMC Infect Dis 2021[Jan]; 21 (1): 57 PMID33435865show ga
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(+)T cell level were older and more often male compared to those with higher CD4(+)T cell level. Reduced CD8(+)T cell level was an indicator of the severity of COVID-19. Both decreased CD4(+)T [HR:13.659; 95%CI: 3.235-57.671] and CD8(+)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(+)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(+)T cell level, not the CD4(+)T cell level, that reflected the severity of the patient's disease. Only reduced CD4(+)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.