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Validation of the T-Lymphocyte Subset Index (TLSI) as a Score to Predict Mortality in Unvaccinated Hospitalized COVID-19 Patients.
Di Lorenzo, Andrea; Tedde, Simona; Pace, Pier Giorgio; Campogiani, Laura; Ansaldo, Lorenzo; Lodi, Alessandra; Zordan, Marta; Barreca, Filippo; Caldara, Federica; Rossi, Benedetta; Imeneo, Alessandra; Alessio, Grazia; Crea, Angela Maria Antonia; Checchi, Davide; Malagnino, Vincenzo; Teti, Elisabetta; Coppola, Luigi; Palmieri, Raffaele; Buccisano, Francesco; Andreoni, Massimo; Sarmati, Loredana; Iannetta, Marco.
  • Di Lorenzo A; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Tedde S; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Pace PG; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Campogiani L; Infectious Disease Clinic, Policlinico Tor Vergata, 00133 Rome, Italy.
  • Ansaldo L; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Lodi A; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Zordan M; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Barreca F; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Caldara F; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Rossi B; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Imeneo A; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Alessio G; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Crea AMA; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Checchi D; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Malagnino V; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Teti E; Infectious Disease Clinic, Policlinico Tor Vergata, 00133 Rome, Italy.
  • Coppola L; Infectious Disease Clinic, Policlinico Tor Vergata, 00133 Rome, Italy.
  • Palmieri R; Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy.
  • Buccisano F; Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy.
  • Andreoni M; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Sarmati L; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
  • Iannetta M; Department of System Medicine, Tor Vergata University, 00133 Rome, Italy.
Biomedicines ; 10(11)2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2099343
ABSTRACT
Lymphopenia has been consistently reported as associated with severe coronavirus disease 2019 (COVID-19). Several studies have described a profound decline in all T-cell subtypes in hospitalized patients with severe and critical COVID-19. The aim of this study was to assess the role of T-lymphocyte subset absolute counts measured at ward admission in predicting 30-day mortality in COVID-19 hospitalized patients, validating a new prognostic score, the T-Lymphocyte Subset Index (TLSI, range 0-2), based on the number of T-cell subset (CD4+ and CD8+) absolute counts that are below prespecified cutoffs. These cutoff values derive from a previously published work of our research group at Policlinico Tor Vergata, Rome, Italy CD3+CD4+ < 369 cells/µL, CD3+CD8+ < 194 cells/µL. In the present single-center retrospective study, T-cell subsets were assessed on admission to the infectious diseases ward. Statistical analysis was performed using JASP (Version 0.16.2. JASP Team, 2022, Amsterdam, The Netherlands) and Prism8 (version 8.2.1. GraphPad Software, San Diego, CA, USA). Clinical and laboratory parameters of 296 adult patients hospitalized because of COVID-19 were analyzed. The overall mortality rate was 22.3% (66/296). Survivors (S) had a statistically significant lower TLSI score compared to non-survivors (NS) (p < 0.001). Patients with increasing TLSI scores had proportionally higher rates of 30-day mortality (p < 0.0001). In the multivariable logistic analysis, the TLSI was an independent predictor of in-hospital 30-day mortality (OR 1.893, p = 0.003). Survival analysis showed that patients with a TLSI > 0 had an increased risk of death compared to patients with a TLSI = 0 (hazard ratio 2.83, p < 0.0001). The TLSI was confirmed as an early and independent predictor of COVID-19 in-hospital 30-day mortality.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Biomedicines10112788

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Biomedicines10112788