Your browser doesn't support javascript.
Lymphocyte subsets early predict mortality in a large series of hospitalized COVID-19 patients in Spain.
Cantenys-Molina, S; Fernández-Cruz, E; Francos, P; Lopez Bernaldo de Quirós, J C; Muñoz, P; Gil-Herrera, J.
  • Cantenys-Molina S; Division of Immunology, Hospital General Universitario 'Gregorio Marañón', Madrid, Spain.
  • Fernández-Cruz E; Division of Immunology, Hospital General Universitario 'Gregorio Marañón', Madrid, Spain.
  • Francos P; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
  • Lopez Bernaldo de Quirós JC; Division of Immunology, Hospital General Universitario 'Gregorio Marañón', Madrid, Spain.
  • Muñoz P; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
  • Gil-Herrera J; Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario 'Gregorio Marañón', Madrid, Spain.
Clin Exp Immunol ; 203(3): 424-432, 2021 03.
Article in English | MEDLINE | ID: covidwho-926453
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
2. Cessation of life AFFECTS Patients
Subject
Cessation of life
Predicate
AFFECTS
Object
Patients
3. Patients LOCATION_OF peripheral blood
Subject
Patients
Predicate
LOCATION_OF
Object
peripheral blood
4. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
5. Comorbidity PROCESS_OF Patients
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Patients
6. Cessation of life PROCESS_OF Patients
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Patients
7. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
8. Cessation of life AFFECTS Patients
Subject
Cessation of life
Predicate
AFFECTS
Object
Patients
9. Patients LOCATION_OF peripheral blood
Subject
Patients
Predicate
LOCATION_OF
Object
peripheral blood
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Comorbidity PROCESS_OF Patients
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Patients
12. Cessation of life PROCESS_OF Patients
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
The role of lymphocytes and their main subsets as prognostic factors of death in SARS-CoV-2-infected patients remains unclear, with no information obtained from patients outside China. We aimed to assess whether measuring lymphocyte subpopulations added clinical value to the total lymphocyte counting regarding mortality when they were simultaneously tested at hospital admission. Peripheral blood was analysed in 701 polymerase chain reaction (PCR)-confirmed consecutive patients by lysed-no washed flow cytometry. Demographic and clinical features were registered in electronic medical records. Statistical analysis was performed after a 3-month follow-up. The 112 patients who died were older and had significantly higher frequencies of known co-morbidities than survivor COVID-19 patients. A significant reduction in total lymphocytes, CD3+ , CD4+ , CD8+ and CD19+ counts and CD3+ percentage was found in the group of deceased patients (P < 0·001), while the percentage of CD56+ /CD16+ natural killer (NK) cells was significantly higher (P < 0·001). Multivariate logistic regression analysis showed a significantly increased risk of in-hospital death associated to age [odds ratio (OR) = 2·36, 95% confidence interval (CI) = 1·9-3·0 P < 0·001]; CD4+  T counts ≤ 500 cells/µl, (OR = 2·79, 95% CI = 1·1-6·7, P = 0·021); CD8+  T counts ≤ 100 cells/µl, (OR = 1·98, 95% CI = 1·2-3·3) P = 0·009) and CD56+ /CD16+ NK ≥ 30%, (OR = 1·97, 95% CI = 1·1-3·1, P = 0·002) at admission, independent of total lymphocyte numbers and co-morbidities, with area under the curve 0·85 (95% CI = 0·81-0·88). Reduced counts of CD4+ and CD8+ T cells with proportional expansion of NK lymphocytes at admission were prognostic factors of death in this Spanish series. In COVID-19 patients with normal levels of lymphocytes or mild lymphopenia, imbalanced lymphocyte subpopulations were early markers of in-hospital mortality.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: CD4-Positive T-Lymphocytes / Antigens, CD / T-Lymphocyte Subsets / Hospital Mortality / CD8-Positive T-Lymphocytes / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Clin Exp Immunol Year: 2021 Document Type: Article Affiliation country: Cei.13547

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: CD4-Positive T-Lymphocytes / Antigens, CD / T-Lymphocyte Subsets / Hospital Mortality / CD8-Positive T-Lymphocytes / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Clin Exp Immunol Year: 2021 Document Type: Article Affiliation country: Cei.13547