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Article

CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study

1
Rheumatology Department, Parc Taulí University Hospital, I3PT Research Institute (UAB), Universitat Autónoma de Barcelona (UAB), 08208 Sabadell, Spain
2
Immunology Unit UDIAT, Parc Taulí University Hospital. I3PT Research Institute (UAB), 08208 Sabadell, Spain
3
Infectious Disease Department, Parc Taulí University Hospital. I3PT Research Institute (UAB), 08208 Sabadell, Spain
4
Pneumology Department, Parc Taulí University Hospital, I3PT Research Institute (UAB), 08208 Sabadell, Spain
5
Biostatistics and Bioinformatics Unit, Institute for Research in Biomedicine Barcelona (IRB Barcelona), 08028 Barcelona, Spain
6
Research Biology Unit, I3PT Research Institute (UAB), 08208 Sabadell, Spain
*
Author to whom correspondence should be addressed.
Received: 7 October 2020 / Revised: 2 November 2020 / Accepted: 3 November 2020 / Published: 9 November 2020
(This article belongs to the Collection Coronaviruses)
Background: COVID-19 pathophysiology and the predictive factors involved are not fully understood, but lymphocytes dysregulation appears to play a role. This paper aims to evaluate lymphocyte subsets in the pathophysiology of COVID-19 and as predictive factors for severe disease. Patient and methods: A prospective cohort study of patients with SARS-CoV-2 bilateral pneumonia recruited at hospital admission. Demographics, medical history, and data regarding SARS-CoV-2 infection were recorded. Patients systematically underwent complete laboratory tests, including parameters related to COVID-19 as well as lymphocyte subsets study at the time of admission. Severe disease criteria were established at admission, and patients were classified on remote follow-up according to disease evolution. Linear regression models were used to assess associations with disease evolution, and Receiver Operating Characteristic (ROC) and the corresponding Area Under the Curve (AUC) were used to evaluate predictive values. Results: Patients with critical COVID-19 showed a decrease in CD3+CD4+ T cells count compared to non-critical (278 (485 IQR) vs. 545 (322 IQR)), a decrease in median CD4+/CD8+ ratio (1.7, (1.7 IQR) vs. 3.1 (2.4 IQR)), and a decrease in median CD4+MFI (21,820 (4491 IQR) vs. 26,259 (3256 IQR)), which persisted after adjustment. CD3+CD8+ T cells count had a high correlation with time to hospital discharge (PC = −0.700 (−0.931, −0.066)). ROC curves for predictive value showed lymphocyte subsets achieving the best performances, specifically CD3+CD4+ T cells (AUC = 0.756), CD4+/CD8+ ratio (AUC = 0.767), and CD4+MFI (AUC = 0.848). Conclusions: A predictive value and treatment considerations for lymphocyte subsets are suggested, especially for CD3CD4+ T cells. Lymphocyte subsets determination at hospital admission is recommended. View Full-Text
Keywords: COVID-19; lymphocyte subsets; CD4+ T cells; predictive value; severity COVID-19; lymphocyte subsets; CD4+ T cells; predictive value; severity
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MDPI and ACS Style

Calvet, J.; Gratacós, J.; Amengual, M.J.; Llop, M.; Navarro, M.; Moreno, A.; Berenguer-Llergo, A.; Serrano, A.; Orellana, C.; Cervantes, M. CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study. Viruses 2020, 12, 1277. https://0-doi-org.brum.beds.ac.uk/10.3390/v12111277

AMA Style

Calvet J, Gratacós J, Amengual MJ, Llop M, Navarro M, Moreno A, Berenguer-Llergo A, Serrano A, Orellana C, Cervantes M. CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study. Viruses. 2020; 12(11):1277. https://0-doi-org.brum.beds.ac.uk/10.3390/v12111277

Chicago/Turabian Style

Calvet, Joan; Gratacós, Jordi; Amengual, María J.; Llop, Maria; Navarro, Marta; Moreno, Amàlia; Berenguer-Llergo, Antoni; Serrano, Alejandra; Orellana, Cristóbal; Cervantes, Manel. 2020. "CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study" Viruses 12, no. 11: 1277. https://0-doi-org.brum.beds.ac.uk/10.3390/v12111277

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