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Study of CD4+ T-lymphocytes in chronic kidney disease patients with COVID-19 infection

Shereen P Aziz1, Amany Abbas1, Sherif A Sayed1

  • 1Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt.

The Egyptian Journal of Immunology
|January 16, 2024
PubMed

Insights

Chronic kidney disease (CKD) significantly lowers CD4+ T-lymphocyte counts, impairing immunity. COVID-19 infection further exacerbates this decline in CKD patients, increasing health risks.

Area of Science:

  • Immunology
  • Nephrology
  • Infectious Diseases

Background:

  • Chronic kidney disease (CKD) is defined as kidney damage lasting over three months.
  • Adaptive cell-mediated immunity, particularly CD4+ T-lymphocytes, plays a crucial role in immune response.
  • The coronavirus disease 2019 (COVID-19) pandemic presented unique challenges for individuals with underlying health conditions like CKD.

Purpose of the Study:

  • To analyze CD4+ T-lymphocyte levels in chronic kidney disease (CKD) patients during the COVID-19 pandemic.
  • To assess the impact of COVID-19 infection on adaptive cell-mediated immunity in CKD patients.
  • To investigate the correlation between CD4+ T-lymphocyte counts, CKD progression, and COVID-19 status.

Main Methods:

  • The study involved 146 participants: 40 CKD patients positive for COVID-19, 44 CKD patients negative for COVID-19, and 62 healthy controls.
  • Absolute CD4+ T-lymphocyte counts were measured using flow cytometry.
  • Statistical analysis, including Odds Ratio calculation, was performed to determine significance.

Main Results:

  • CKD patients exhibited significantly lower absolute CD4+ T-lymphocyte counts compared to controls (Odds Ratio: 72.63, p=0.0001).
  • COVID-19 infection in CKD patients was associated with a more than six-fold decrease in CD4+ T-lymphocytes compared to controls.
  • A significant correlation was observed between decreased CD4+ T-lymphocyte counts and advanced stages of CKD. CKD patients with COVID-19 were 50% more likely to have lower CD4+ T-lymphocyte levels than those without COVID-19.

Conclusions:

  • CKD significantly alters the immune system, leading to decreased CD4+ T-lymphocyte levels, especially in advanced stages.
  • COVID-19 infection further compromises immune function in CKD patients, increasing vulnerability.
  • The combination of CKD and COVID-19 may lead to poor immune response, increased morbidity, and mortality.

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