Abstract
BackgroundIn December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei, China. And, it has become a global pandemic. Describe the patient's clinical symptoms in detail, finding markers that predict the prognosis of patients with COVID-19 are of great value.MethodsIn this multicenter, retrospective study, 476 patients with COVID-19 were recruited 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.ResultsThe dominant symptoms observed in the study included fever on admission, cough, fatigue, and shortness of breath. The most frequent comorbidities were hypertension and diabetes. Compared with patients with higher CD4+T cell levels, patients with lower CD4+T cell levels were older and were more frequently male. Reduction of CD8+T cell is an indicator of the severity of COVID-19. Both decreased CD4+T cell [HR:13.659; 95%CI: 3.235-57.671] and CD8+T cell [HR: 10.883; 95%CI: 3.277-36.145] were associated with in-hospital death in COVID-19 patients, but only decreased CD4+T cell was an independent predictor of in-hospital death in COVID-19 patients.ConclusionsReductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe cases. It was the CD8+T cell, not the CD4+T cell, that reflected the severity of the patient’s disease. Only CD4+T cell reduction 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. https://clinicaltrials.gov/ct2/show/NCT04292964.
T-lymphocyte subsets in lung transplant recipients: association between nadir CD4 T-cell count and viral infections after transplantation
