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Published on: September 20, 2024
Kinetics of Immune Subsets in COVID-19 Patients Treated with Corticosteroids
Apostolos Georgios Pappas1,2,3, Anna-Louiza Chaliasou3,4, Andreas Panagopoulos3,5
11st Department of Critical Care and Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, "Evangelismos" General Hospital, 10676 Athens, Greece.
Rationale:
Changes in anti-SARS-CoV-2 defense immune subsets in patients treated with dexamethasone (DXM) for severe COVID-19 and their relation to disease outcomes are poorly understood.
Methods:
Blood-lymphocyte subsets of 110 hospitalized COVID-19 patients were prospectively examined. A first sample was taken at enrollment and a second one 7-10 days later. Total B-, T-lymphocytes, CD4+, CD8+, T-regulatory (Treg), Natural-Killer (NK) and NK T-cells were counted using flow cytometry.
Results:
At enrollment, patients with respiratory failure, characterized by DXM failure (intubation/death) or DXM success (hospital discharge) exhibited significantly fewer CD3+, CD4+ and CD8+ cells and B-lymphocytes compared to the control group (no respiratory failure/no DXM). At the time of treatment completion, the DXM-failure group exhibited significantly fewer CD3+, CD4+ and CD8+ cells, memory CD4+ and CD8+ T-lymphocytes, compared to the control and the DXM-success groups and fewer activated CD4+ T-lymphocytes, Tregs and NK cells compared to the control group. At the time of treatment completion, the number of all investigated lymphocyte subsets increased in the DXM-success group and was similar to those of the control group. NK cells significantly decreased over time in the DXM-failure group.
Conclusion:
The lymphocyte kinetics differ between DXM-treated and control COVID-19 patients and are associated with clinical outcomes.
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