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Individuals With Higher CD4/CD8 Ratio Exhibit Increased Risk of Acute Respiratory Distress Syndrome and In-Hospital Mortality During Acute SARS-CoV-2 Infection.
Pascual-Dapena, Ana; Chillaron, Juan José; Llauradó, Gemma; Arnau-Barres, Isabel; Flores, Juana; Lopez-Montesinos, Inmaculada; Sorlí, Luisa; Luis Martínez-Pérez, Juan; Gómez-Zorrilla, Silvia; Du, Juan; García-Giralt, Natalia; Güerri-Fernández, Robert.
  • Pascual-Dapena A; Medicine and Life Sciences Department, Pompeu Fabra University, Barcelona, Spain.
  • Chillaron JJ; Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, Spain.
  • Llauradó G; Endocrinology Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
  • Arnau-Barres I; Endocrinology Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
  • Flores J; Geriatrics Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
  • Lopez-Montesinos I; Endocrinology Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
  • Sorlí L; Infectious Diseases Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
  • Luis Martínez-Pérez J; Infectious Diseases Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
  • Gómez-Zorrilla S; Medicine and Life Sciences Department, Pompeu Fabra University, Barcelona, Spain.
  • Du J; Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, Spain.
  • García-Giralt N; Infectious Diseases Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
  • Güerri-Fernández R; Infectious Diseases Department, Hospital del Mar Institute of Medical Research, Barcelona, Spain.
Front Med (Lausanne) ; 9: 924267, 2022.
Article in English | MEDLINE | ID: covidwho-1933710
ABSTRACT

Background:

CD4/CD8 ratio has been used as a quantitative prognostic risk factor in patients with viral infections. This study aims to assess the association between in-hospital mortality and at admission CD4/CD8 ratio among individuals with acute SARS-CoV-2 infection.

Methods:

This is a longitudinal cohort study with data of all consecutive patients admitted to the COVID-19 unit at Hospital del Mar, Barcelona, Spain for ≥48 h between March to May 2020. The CD4+ CD8+ T-cell subset differentiation was assessed by flow cytometry at admission as well as a complete blood test. Patients were classified according to CD4/CD8 ratio tertiles. The primary outcome was in-hospital mortality and the secondary outcome was acute respiratory distress (ARDS).

Results:

A total of 338 patients were included in the cohort. A high CD4/CD8 ratio (third tertile) was associated with a higher in-hospital mortality [adjusted Cox model hazard ratio (HR) 4.68 (95%CI 1.56-14.04, p = 0.006), reference second tertile HR 1]. Similarly, a high CD4/CD8 ratio (third tertile) was associated with a higher incidence of ARDS [adjusted logistic regression model OR 1.97 (95%CI 1.11-3.55, p = 0.022) reference second tertile HR 1]. There was a trend of higher in-hospital mortality and incidence of ARDS in patients within the first tertile of CD4/CD8 ratio compared with the second one, but the difference was not significant. No associations were found with total lymphocyte count or inflammatory parameters, including D-dimer.

Conclusion:

CD4/CD8 ratio is a prognostic factor for the severity of COVID-19, reflecting the negative impact on prognosis of those individuals whose immune response has abnormal CD8+ T-cell expansion during the early response to the infection.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2022 Document Type: Article Affiliation country: Fmed.2022.924267

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2022 Document Type: Article Affiliation country: Fmed.2022.924267