Individuals With Higher CD4/CD8 Ratio Exhibit Increased Risk of Acute Respiratory Distress Syndrome and In-Hospital Mortality During Acute SARS-CoV-2 Infection
Pascual-Dapena, Ana (Universitat Autònoma de Barcelona. Departament de Medicina)
Chillaron, Juan Jose (Institut Hospital del Mar d'Investigacions Mèdiques)
Llauradó, Gemma (Institut Hospital del Mar d'Investigacions Mèdiques)
Arnau-Barrés, Isabel (Institut Hospital del Mar d'Investigacions Mèdiques)
Flores, Juana (Institut Hospital del Mar d'Investigacions Mèdiques)
Lopez-Montesinos, Inmaculada (Institut Hospital del Mar d'Investigacions Mèdiques)
Sorlí, Luisa (Institut Hospital del Mar d'Investigacions Mèdiques)
Luis Martínez-Pérez, Juan (Universitat Autònoma de Barcelona. Departament de Medicina)
Gómez-Zorrilla, Silvia (Institut Hospital del Mar d'Investigacions Mèdiques)
Du, Juan (Institut Hospital del Mar d'Investigacions Mèdiques)
Garcia-Giralt, Natalia (Institut Hospital del Mar d'Investigacions Mèdiques)
Güerri-Fernández, Robert (Institut Hospital del Mar d'Investigacions Mèdiques)

Data:	2022
Resum:	CD4/CD8 ratio has been used as a quantitative prognostic risk factor in patients with viral infections. This study aims to assess the association between in-hospital mortality and at admission CD4/CD8 ratio among individuals with acute SARS-CoV-2 infection. This is a longitudinal cohort study with data of all consecutive patients admitted to the COVID-19 unit at Hospital del Mar, Barcelona, Spain for ≥48 h between March to May 2020. The CD4+ CD8+ T-cell subset differentiation was assessed by flow cytometry at admission as well as a complete blood test. Patients were classified according to CD4/CD8 ratio tertiles. The primary outcome was in-hospital mortality and the secondary outcome was acute respiratory distress (ARDS). A total of 338 patients were included in the cohort. A high CD4/CD8 ratio (third tertile) was associated with a higher in-hospital mortality [adjusted Cox model hazard ratio (HR) 4. 68 (95%CI 1. 56-14. 04, p = 0. 006), reference: second tertile HR 1]. Similarly, a high CD4/CD8 ratio (third tertile) was associated with a higher incidence of ARDS [adjusted logistic regression model OR 1. 97 (95%CI 1. 11-3. 55, p = 0. 022) reference: second tertile HR 1]. There was a trend of higher in-hospital mortality and incidence of ARDS in patients within the first tertile of CD4/CD8 ratio compared with the second one, but the difference was not significant. No associations were found with total lymphocyte count or inflammatory parameters, including D-dimer. CD4/CD8 ratio is a prognostic factor for the severity of COVID-19, reflecting the negative impact on prognosis of those individuals whose immune response has abnormal CD8+ T-cell expansion during the early response to the infection.
Ajuts:	Ministerio de Economía y Competitividad CB16/10/00245 Ministerio de Economía y Competitividad PI16/01860 Instituto de Salud Carlos III PI19/00019
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	ARDS ; CD4/CD8 ratio ; Mortality ; Prognose ; SARS-CoV-2
Publicat a:	Frontiers in Medicine, Vol. 9 (june 2022) , ISSN 2296-858X

DOI: 10.3389/fmed.2022.924267
PMID: 35814752

7 p, 1.8 MB

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