Clinical characteristics and predictive value of lower CD4(+)T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study.
Clinical characteristics and predictive value of lower CD4(+)T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study.
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DOI：
10.1186/s12879-020-05741-w
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发表时间：
2021-01-12
影响因子：
3.7
通讯作者：
Zhang DY
中科院分区：
文献类型：
--
作者：
Wen XS;Jiang D;Gao L;Zhou JZ;Xiao J;Cheng XC;He B;Chen Y;Lei P;Tan XW;Qin S;Zhang DY
2019年12月，中国湖北武汉出现由严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）。此外，它已成为一种全球流行病。这对于详细描述COVID-19患者的临床症状和寻找对预测COVID-19患者预后有意义的标志物具有重要价值。在这项多中心、回顾性研究中，476名COVID-19患者从一个连续系列中入组。筛选后，共有395例患者入选本研究。全因死亡是主要终点。所有患者均随访至出院或死亡。研究中观察到的主要症状包括入院时发热、咳嗽、疲劳和呼吸急促。最常见的合并症是高血压和糖尿病。与CD 4 + T细胞水平较高的患者相比，CD 4 +T细胞水平较低的患者年龄更大，更常见于男性。CD 8 +T细胞水平降低是COVID-19严重程度的指标。CD 4 +T [HR：13.659; 95%CI：3.235-57.671]和CD 8 +T [HR：10.883; 95%CI：3.277-36.145]细胞水平降低均与COVID-19患者的院内死亡相关，但只有CD 4 +T细胞水平降低是COVID-19患者院内死亡的独立预测因子。淋巴细胞和淋巴细胞亚群的减少在COVID-19患者中很常见，特别是在COVID-19的重症病例中。反映患者疾病严重程度的是CD 8 +T细胞水平，而不是CD 4 +T细胞水平。只有CD 4 +T细胞水平降低与COVID-19患者的住院死亡率增加独立相关。COVID-19患者的预后因素，NCT 04292964。2020年3月3日注册。已登记的逆行。在线版本包含补充材料，可通过10.1186/s12879-020-05741-w获得。
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. 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. 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. 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. Prognostic Factors of Patients With COVID-19, NCT04292964. Registered 03 March 2020. Retrospectively registered. The online version contains supplementary material available at 10.1186/s12879-020-05741-w.
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影响因子：
5.8
作者：
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通讯作者：
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影响因子：
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DOI：
10.1016/s1473-3099(20)30243-7
发表时间：
2020-06-01
期刊：
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