scholarly journals Clinical Characteristics and Predictive Value of low CD4+T Count in Patients with Moderate and Severe COVID-19: A Multicenter Retrospective Study

2020 ◽  
Author(s):  
Xue-song Wen ◽  
Lei Gao ◽  
Dan Jiang ◽  
Xiao-cheng Cheng ◽  
Bin He ◽  
...  
Keyword(s):  
T Cells ◽  
Retrospective Study ◽  
T Cell ◽  
Cell Count ◽  
Clinical Symptoms ◽  
Hospital Death ◽  
Consecutive Series ◽  
Laboratory Findings ◽  
Global Pandemic ◽  
Lower Limit Of Normal

Abstract 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. 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 cells level, patients with lower CD4+T cells level were older and were more frequently male. In terms of laboratory findings, lymphocyte count, CD4+T cell count, CD8+T cell count were significantly lower in low group than in higher group. The case in-hospital death rate was significant higher in patients with lower CD4+T level. After adjusting for potential confounding factors, CD4+T count below the lower limit of normal showed independent prognostic value for all-cause in-hospital death in patients with COVID-19. Conclusions: Reductions in lymphocytes and lymphocyte subsets are common in COVID-19 patients, especially in severe cases. It is the CD8+T count, not the CD4+T count, that reflected the severity of the patient’s disease. Lower CD4+T count is independently associated with an increased rate of in-hospital death. Trial registration: Prognostic Factors of Patients With COVID-19, NCT04292964. Registered 03 March 2020. https://clinicaltrials.gov/ct2/show/NCT04292964.

scholarly journals Clinical characteristics and predictive value of lower CD4+T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xue-song Wen ◽  
Dan Jiang ◽  
Lei Gao ◽  
Jian-zhong Zhou ◽  
Jun Xiao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
T Cell ◽  
Lymphocyte Subsets ◽  
Clinical Symptoms ◽  
Independent Predictor ◽  
Cd4 T Cell ◽  
Hospital Death ◽  
Consecutive Series ◽  
Cell Level ◽  
Global Pandemic

Abstract 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.

scholarly journals Clinical characteristics and predictive value of low CD4+T cell count in patients with moderate and severe COVID-19: A multicenter retrospective study

2020 ◽  
Author(s):  
Xue-song Wen ◽  
Lei Gao ◽  
Dan Jiang ◽  
Xiao-cheng Cheng ◽  
Bin He ◽  
...  
Keyword(s):  
Retrospective Study ◽  
T Cell ◽  
Lymphocyte Subsets ◽  
Clinical Symptoms ◽  
Independent Predictor ◽  
Cd4 T Cell ◽  
Hospital Death ◽  
Consecutive Series ◽  
Global Pandemic ◽  
Cd4 T Cell Count

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.

scholarly journals Clinical characteristics and predictive value of lower CD4+T cell level in patients with moderate and severe COVID-19: A multicenter retrospective study

2021 ◽  
Author(s):  
Xue-song Wen ◽  
Dan Jiang ◽  
Lei Gao ◽  
Jian zhong Zhou ◽  
Jun Xiao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
T Cell ◽  
Lymphocyte Subsets ◽  
Clinical Symptoms ◽  
Independent Predictor ◽  
Cd4 T Cell ◽  
Hospital Death ◽  
Consecutive Series ◽  
Cell Level ◽  
Global Pandemic

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. 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.MethodsIn 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.ResultsThe 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.ConclusionsReductions 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. https://clinicaltrials.gov/ct2/show/NCT04292964. Retrospectively registered.

scholarly journals Clinical characteristics and predictive value of lower CD4+T cell level in patients with moderate and severe COVID-19: A multicenter retrospective study

2020 ◽  
Author(s):  
Xue-song Wen ◽  
Dan Jiang ◽  
Lei Gao ◽  
Jian zhong Zhou ◽  
Jun Xiao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
T Cell ◽  
Lymphocyte Subsets ◽  
Clinical Symptoms ◽  
Independent Predictor ◽  
Cd4 T Cell ◽  
Hospital Death ◽  
Consecutive Series ◽  
Cell Level ◽  
Global Pandemic

Abstract 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. And, it has become a global pandemic. This is of great value for describing the patient's clinical symptoms in detail and looking for markers which are significant to predict the prognosis of patients with COVID-19.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 common comorbidities were hypertension and diabetes. Compared with patients with higher CD4+T cell level, patients with lower CD4+T cell level were older and mostly males. The reduction of CD8+T cell level is 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. ConclusionsReductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe COVID-19 cases. It was the CD8+T cell level, not the CD4+T cell level, that reflected the severity of the patient’s disease. Only the reduction in CD4+T cell level was independently associated with increased in-hospital death in COVID-19 patients.

scholarly journals HIV-Related Arterial Stiffness in Malawian Adults Is Associated With the Proportion of PD-1–Expressing CD8+ T Cells and Reverses With Antiretroviral Therapy

2019 ◽  
Vol 219 (12) ◽  
pp. 1948-1958 ◽  
Author(s):  
Christine Kelly ◽  
Henry C Mwandumba ◽  
Robert S Heyderman ◽  
Kondwani Jambo ◽  
Raphael Kamng’ona ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Arterial Stiffness ◽  
Cell Count ◽  
Cd8 T Cells ◽  
Sub Saharan Africa ◽  
Cd4 T Cell ◽  
Sub Saharan ◽  
Cd4 T Cell Count

Abstract Background The contribution of immune activation to arterial stiffness and its reversibility in human immunodeficiency virus (HIV)–infected adults in sub-Saharan Africa is unknown. Methods HIV-uninfected and HIV-infected Malawian adults initiating antiretroviral therapy (ART) with a CD4+ T-cell count of <100 cells/μL were enrolled and followed for 44 weeks; enrollment of infected adults occurred 2 weeks after ART initiation. We evaluated the relationship between carotid femoral pulse wave velocity (cfPWV) and T-cell activation (defined as HLA-DR+CD38+ T cells), exhaustion (define as PD-1+ T cells), and senescence (defined as CD57+ T cells) and monocyte subsets, using normal regression. Results In 279 HIV-infected and 110 HIV-uninfected adults, 142 (37%) had hypertension. HIV was independently associated with a 12% higher cfPWV (P = .02) at baseline and a 14% higher cfPWV at week 10 (P = .02), but the increases resolved by week 22. CD4+ and CD8+ T-cell exhaustion were independently associated with a higher cfPWV at baseline (P = .02). At 44 weeks, arterial stiffness improved more in those with greater decreases in the percentage of CD8+ T cells and the percentage of PD-1+CD8+ T cells (P = .01 and P = .03, respectively). When considering HIV-infected participants alone, the adjusted arterial stiffness at week 44 tended to be lower in those with higher baseline percentage of PD-1+CD8+ T cells (P = .054). Conclusions PD-1+CD8+ T-cells are associated with HIV-related arterial stiffness, which remains elevated during the first 3 months of ART. Resources to prevent cardiovascular disease in sub-Saharan Africa should focus on blood pressure reduction and individuals with a low CD4+ T-cell count during early ART.

scholarly journals The Impact of T Cell Vaccination in Alleviating and Regulating Systemic Lupus Erythematosus Manifestation

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Liuye Huang ◽  
Yuan Yang ◽  
Yu Kuang ◽  
Dapeng Wei ◽  
Wanyi Li ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cells ◽  
T Cell ◽  
Side Effects ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Systemic Lupus ◽  
T Cell Vaccination ◽  
Dna Antibodies

Objective. Systemic lupus erythematosus (SLE) is an autoimmune disease identified by a plethora of production of autoantibodies. Autoreactive T cells may play an important role in the process. Attenuated T cell vaccination (TCV) has proven to benefit some autoimmune diseases by deleting or suppressing pathogenic T cells. However, clinical evidence for TCV in SLE is still limited. Therefore, this self-controlled study concentrates on the clinical effects of TCV on SLE patients. Methods. 16 patients were enrolled in the study; they accepted TCV regularly. SLEDAI, clinical symptoms, blood parameters including complements 3 and 4 levels, ANA, and anti-ds-DNA antibodies were tested. In addition, the side effects and drug usage were observed during the patients’ treatment and follow-up. Results. Remissions in clinical symptoms such as facial rash, vasculitis, and proteinuria were noted in most patients. There are also evident reductions in SLEDAI, anti-ds-DNA antibodies, and GC dose and increases in C3 and C4 levels, with no pathogenic side effects during treatment and follow-up. Conclusions. T cell vaccination is helpful in alleviating and regulating systemic lupus erythematosus manifestation.

scholarly journals PIMATM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Mandisa Skhosana ◽  
Shabashini Reddy ◽  
Tarylee Reddy ◽  
Siphelele Ntoyanto ◽  
Elizabeth Spooner ◽  
...  
Keyword(s):  
South Africa ◽  
T Cells ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Point Of Care ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Kwazulu Natal ◽  
Cd4 T Cell Count

Introduction: Limited information is available on the usefulness of the PIMATM analyser in predicting antiretroviral treatment eligibility and outcome in a primary healthcare clinic setting in disadvantaged communities in KwaZulu-Natal, South Africa.Materials and methods: The study was conducted under the eThekwini Health Unit, Durban, KwaZulu-Natal. Comparison of the enumeration of CD4+ T-cells in 268 patients using the PIMATM analyser and the predicate National Health Laboratory Services (NHLS) was undertaken during January to July 2013. Bland-Altman analysis to calculate bias and limits of agreement, precision and levels of clinical misclassification at various CD4+ T-cell count thresholds was performed.Results: There was high precision of the PIMATM control bead cartridges with low and normal CD4+ T-cell counts using three different PIMATM analysers (%CV < 5). Under World Health Organization (WHO) guidelines (≤ 500 cells/mm3), the sensitivity of the PIMATM analyser was 94%, specificity 78% and positive predictive value (PPV) 95%. There were 24 (9%) misclassifications, of which 13 were false-negative in whom the mean bias was 149 CD4+ T-cells/mm3. Most (87%) patients returned for their CD4 test result but only 67% (110/164) of those eligible (≤ 350 cells/mm3) were initiated on antiretroviral therapy (ART) with a time to treatment of 49 days (interquartile range [IQR], 42–64 days).Conclusion: There was adequate agreement between PIMATM analyser and predicate NHLS CD4+ T-cell count enumeration (≤ 500 cells/mm3) in adult HIV-positive individuals. The high PPV, sensitivity and acceptable specificity of the PIMATM analyser technology lend it as a reliable tool in predicting eligibility and rapid linkage to care in ART programmes.Keywords: HIV; Point of Care; PIMATM CD4+ T cell counts; antiretroviral therapy; prediction/eligibility; South Africa

scholarly journals High Parasite Burdens Cause Liver Damage in Mice following Plasmodium berghei ANKA Infection Independently of CD8+T Cell-Mediated Immune Pathology

2011 ◽  
Vol 79 (5) ◽  
pp. 1882-1888 ◽  
Author(s):  
Ashraful Haque ◽  
Shannon E. Best ◽  
Fiona H. Amante ◽  
Anne Ammerdorffer ◽  
Fabian de Labastida ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Liver Damage ◽  
Plasmodium Berghei ◽  
Clinical Symptoms ◽  
Neurological Symptoms ◽  
Experimental Cerebral Malaria ◽  
Content Type ◽  
Immune Pathology ◽  
The Brain

ABSTRACTInfection of C57BL/6 mice withPlasmodium bergheiANKA induces a fatal neurological disease commonly referred to as experimental cerebral malaria. The onset of neurological symptoms and mortality depend on pathogenic CD8+T cells and elevated parasite burdens in the brain. Here we provide clear evidence of liver damage in this model, which precedes and is independent of the onset of neurological symptoms. Large numbers of parasite-specific CD8+T cells accumulated in the liver followingP. bergheiANKA infection. However, systemic depletion of these cells at various times during infection, while preventing neurological symptoms, failed to protect against liver damage or ameliorate it once established. In contrast, rapid, drug-mediated removal of parasites prevented hepatic injury if administered early and quickly resolved liver damage if administered after the onset of clinical symptoms. These data indicate that CD8+T cell-mediated immune pathology occurs in the brain but not the liver, while parasite-dependent pathology occurs in both organs duringP. bergheiANKA infection. Therefore, we show thatP. bergheiANKA infection of C57BL/6 mice is a multiorgan disease driven by the accumulation of parasites, which is also characterized by organ-specific CD8+T cell-mediated pathology.

scholarly journals A Pathogenic Role for Myelin-Specific Cd8+ T Cells in a Model for Multiple Sclerosis

2001 ◽  
Vol 194 (5) ◽  
pp. 669-676 ◽  
Author(s):  
Eric S. Huseby ◽  
Denny Liggitt ◽  
Thea Brabb ◽  
Bryan Schnabel ◽  
Claes Öhlén ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
T Cells ◽  
T Cell ◽  
Cd8 T Cells ◽  
Demyelinating Disease ◽  
Clinical Symptoms ◽  
Autoimmune Encephalomyelitis ◽  
Effector Cells ◽  
Cns Autoimmunity ◽  
The Central Nervous System

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) characterized by plaques of infiltrating CD4+ and CD8+ T cells. Studies of MS and experimental autoimmune encephalomyelitis (EAE), an animal model of MS, focus on the contribution of CD4+ myelin-specific T cells. The role of CD8+ myelin-specific T cells in mediating EAE or MS has not been described previously. Here, we demonstrate that myelin-specific CD8+ T cells induce severe CNS autoimmunity in mice. The pathology and clinical symptoms in CD8+ T cell–mediated CNS autoimmunity demonstrate similarities to MS not seen in myelin-specific CD4+ T cell–mediated EAE. These data suggest that myelin-specific CD8+ T cells could function as effector cells in the pathogenesis of MS.

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