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Time-course analysis reveals that corticosteroids resuscitate diminished CD8+ T cells in COVID-19: a retrospective
Fangzhou Ye1,2, Jing Liu1,2, Liangkai Chen3
1Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Early low-dose corticosteroid treatment in COVID-19 patients accelerated CD8+ T cell recovery, aiding in the battle against SARS-CoV-2. This finding highlights the potential of immune modulation in critical coronavirus disease 2019 cases.
Area of Science:
- Immunology
- Virology
- Pharmacology
Background:
- Coronavirus disease 2019 (COVID-19) is associated with significant immune dysregulation, including alterations in CD8+ T cell counts and coagulation parameters.
- Understanding the impact of therapeutic interventions on these parameters is crucial for managing severe COVID-19.
Purpose of the Study:
- To investigate the effects of corticosteroids and heparin on CD8+ T cells and D-dimer levels in COVID-19 patients.
- To explore the time-course association of coagulation, inflammation, and immunity parameters in relation to COVID-19 severity.
Main Methods:
- Retrospective cohort study of 866 COVID-19 patients, categorized by disease severity.
- Generalized additive models to analyze time-course associations of key parameters.
- Segmented regression to assess the influence of corticosteroids and heparin on CD8+ T cells and D-dimer.
Main Results:
- Critically ill COVID-19 patients exhibited synchronous changes in neutrophil-to-lymphocyte ratio (NLR), D-dimer, and CD8+ T cell levels.
- Early administration of methylprednisolone (before 14 days post-discharge or at doses <40mg/day) significantly increased the rate of CD8+ T cell recovery between 14-56 days post-discharge.
Conclusions:
- Longitudinal correlations were observed between coagulation, inflammation, and immunity parameters in COVID-19 patients.
- Early, low-dose corticosteroid treatment appears to accelerate CD8+ T cell recovery in critical COVID-19 cases, potentially enhancing the immune response against SARS-CoV-2.
Objective:
To illustrate the effect of corticosteroids and heparin, respectively, on coronavirus disease 2019 (COVID-19) patients' CD8+ T cells and D-dimer.
Methods:
In this retrospective cohort study involving 866 participants diagnosed with COVID-19, patients were grouped by severity. Generalized additive models were established to explore the time-course association of representative parameters of coagulation, inflammation and immunity. Segmented regression was performed to examine the influence of corticosteroids and heparin upon CD8+ T cell and D-dimer, respectively.
Results:
There were 541 moderate, 169 severe and 156 critically ill patients involved in the study. Synchronous changes of levels of NLR, D-dimer and CD8+ T cell in critically ill patients were observed. Administration of methylprednisolone before 14 DFS compared with those after 14 DFS (β = 0.154%, 95% CI=(0, 0.302), p=.048) or a dose lower than 40 mg per day compared with those equals to 40 mg per day (β = 0.163%, 95% CI=(0.027, 0.295), p=.020) significantly increased the rising rate of CD8+ T cell in 14-56 DFS.
Conclusions:
The parameters of coagulation, inflammation and immunity were longitudinally correlated, and an early low-dose corticosteroid treatment accelerated the regaining of CD8+ T cell to help battle against SARS-Cov-2 in critical cases of COVID-19.
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