Related Experiment Video
Updated: Jul 31, 2026
In Vitro Assay to Evaluate the Impact of Immunoregulatory Pathways on HIV-specific CD4 T Cell Effector Function
Published on: October 15, 2013
Clinical characteristics and predictive value of lower CD4+T cell level in patients with moderate and severe
Xue-Song Wen1, Dan Jiang1, Lei Gao1
1Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, No 1, Youyi Road, Chongqing, 400016, China.
Insights
Reduced CD4+ T cell levels predict in-hospital death in COVID-19 patients. While CD8+ T cell counts indicate disease severity, only CD4+ T cell reduction independently predicts mortality in coronavirus disease 2019.
Area of Science:
- Immunology
- Infectious Diseases
- Clinical Medicine
Background:
- The emergence of coronavirus disease 2019 (COVID-19) has led to a global pandemic.
- Understanding clinical symptoms and identifying prognostic markers for COVID-19 patients is crucial.
Purpose of the Study:
- To investigate prognostic factors for COVID-19 patients.
- To identify markers associated with in-hospital death in COVID-19 patients.
Main Methods:
- A multicenter, retrospective study.
- Inclusion of 395 patients with COVID-19 from an initial cohort of 476.
- All-cause death as the primary endpoint, with follow-up from admission to discharge or death.
Main Results:
- Common symptoms included fever, cough, fatigue, and shortness of breath; hypertension and diabetes were prevalent comorbidities.
- Reduced CD8+ T cell levels indicated COVID-19 severity.
- Both decreased CD4+ T and CD8+ T cell levels were associated with in-hospital death, but only reduced CD4+ T cell levels independently predicted it.
Conclusions:
- Lymphocyte and subset reductions are common in COVID-19, particularly in severe cases.
- CD8+ T cell levels reflect disease severity, whereas reduced CD4+ T cell levels are an independent predictor of in-hospital mortality in COVID-19 patients.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
Trial Registration:
Prognostic Factors of Patients With COVID-19, NCT04292964 . Registered 03 March 2020. Retrospectively registered.
