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T-cell immune response predicts the risk of critical SARS-Cov2 infection in hospitalized COVID-19 patients

INTRODUCTION: This study aimed to identify markers of disease worsening in patients hospitalized for SARS-Cov2 infection. PATIENTS AND METHODS: Patients hospitalized for severe recent-onset (<1 week) SARS-Cov2 infection were prospectively included. The percentage of T-cell subsets and plasma IL-6...

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Detalles Bibliográficos
Autores principales: Samson, Maxime, Nicolas, Barbara, Ciudad, Marion, Greigert, Hélène, Guilhem, Alexandre, Cladiere, Claudie, Straub, Cécile, Blot, Mathieu, Piroth, Lionel, Rogier, Thomas, Devilliers, Hervé, Manckoundia, Patrick, Ghesquiere, Thibault, Francois, Stéphanie, Lakomy, Daniela, Audia, Sylvain, Bonnotte, Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier B.V. on behalf of European Federation of Internal Medicine. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9163020/
https://www.ncbi.nlm.nih.gov/pubmed/35690570
http://dx.doi.org/10.1016/j.ejim.2022.06.001
Descripción
Sumario:INTRODUCTION: This study aimed to identify markers of disease worsening in patients hospitalized for SARS-Cov2 infection. PATIENTS AND METHODS: Patients hospitalized for severe recent-onset (<1 week) SARS-Cov2 infection were prospectively included. The percentage of T-cell subsets and plasma IL-6 at admission (before any steroid therapy) were compared between patients who progressed to a critical infection and those who did not. RESULTS: Thirty-seven patients (18 men, 19 women) were included; 11 (30%) progressed to critical infection. At admission, the critical infection patients were older (P = 0.021), had higher creatinine levels (P = 0.003), and decreased percentages of circulating B cells (P = 0.04), T cells (P = 0.009), and CD4+ T cells (P = 0.004) than those with a favorable course. Among T cell subsets, there was no significant difference between the two groups except for the percentage of Th17 cells, which was two-fold higher in patients who progressed to critical infection (P = 0.028). Plasma IL-6 at admission was also higher in this group (P = 0.018). In multivariate analysis, the percentage of circulating Th17 cells at admission was the only variable associated with higher risk of progression to critical SARS-Cov2 infection (P = 0.021). CONCLUSION: This study suggests that an elevated percentage of Th17 cells in patients hospitalized for SARS-Cov2 infection is associated with an increased risk of progression to critical disease. If these data are confirmed in a larger study, this marker could be used to better target the population of patients in whom tocilizumab could decrease the risk of progression to critical COVID-19.