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Published on: September 20, 2024
CD8+ T cells predicted the conversion of common covid-19 to severe
Li Liu1, Zhiyong Chen2, Yingrong Du3
1Department of Liver Disease, The Third People's Hospital of Kunming City, Yunnan, China. liuli197210@163.com.
Insights
CD8+ T cells and lactate levels can predict the progression of common COVID-19 to severe disease. This finding aids in early identification and management of high-risk patients.
Area of Science:
- Immunology
- Infectious Diseases
- Clinical Medicine
Background:
- Common COVID-19 can progress to severe disease, necessitating identification of predictive biomarkers.
- Understanding T-lymphoid subset dynamics is crucial for predicting disease severity.
Purpose of the Study:
- To evaluate the predictive value of T-lymphoid subsets, specifically CD8+ T cells, in the conversion of common COVID-19 to severe disease.
- To establish and validate a prediction model for COVID-19 severity.
Main Methods:
- Retrospective collection of laboratory data from common COVID-19 patients.
- Univariate and multivariate logistic regression analysis to identify risk factors.
- External validation of the prediction model using a separate dataset.
Main Results:
- Lactate and CD8+ T cells were identified as independent risk factors for disease progression.
- The prediction model demonstrated strong predictive accuracy, with an AUC of 0.906 in the validation set.
- CD8+ T cell levels showed significant predictive value for identifying patients likely to develop severe COVID-19.
Conclusions:
- CD8+ T cells are a significant independent risk factor for predicting the transition from common to severe COVID-19.
- The developed prediction model, incorporating CD8+ T cells, offers a reliable tool for assessing COVID-19 severity risk.
- Early monitoring of CD8+ T cell counts may aid in timely clinical intervention for high-risk COVID-19 patients.
Abstract:
To evaluate the predictive effect of T-lymphoid subsets on the conversion of common covid-19 to severe. The laboratory data were collected retrospectively from common covid-19 patients in the First People's Hospital of Zaoyang, Hubei Province, China and the Third People's Hospital of Kunming, Yunnan Province, China, between January 20, 2020 and March 15, 2020 and divided into training set and validation set. Univariate and multivariate logistic regression was performed to investigate the risk factors for the conversion of common covid-19 to severe in the training set, the prediction model was established and verified externally in the validation set. 60 (14.71%) of 408 patients with common covid-19 became severe in 6-10 days after diagnosis. Univariate and multiple logistic regression analysis revealed that lactate (P = 0.042, OR = 1097.983, 95% CI 1.303, 924,798.262) and CD8+ T cells (P = 0.010, OR = 0.903, 95% CI 0.835, 0.975) were independent risk factors for general type patients to turn to severe type. The area under ROC curve of lactate and CD8+ T cells was 0.754 (0.581, 0.928) and 0.842 (0.713, 0.970), respectively. The actual observation value was highly consistent with the prediction model value in curve fitting. The established prediction model was verified in 78 COVID-19 patients in the verification set, the area under the ROC curve was 0.906 (0.861, 0.981), and the calibration curve was consistent. CD8+ T cells, as an independent risk factor, could predict the transition from common covid-19 to severe.
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