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Early T-Lymphocyte Depletion Predicts Mortality in Critically Ill Children With Severe Infections: An Exploratory

Zimei Cheng1,2,3, Jinxin Wang1,2, Caiyan Zhang1,2

  • 1Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.

Critical Care Medicine
|January 22, 2026
PubMed

Insights

Severe infections in children can cause low T cell counts, increasing mortality risk. Platelet-derived growth factor (PDGF)-AA plays a key role in this process, highlighting the importance of early immune profiling.

Area of Science:

  • Pediatric critical care medicine
  • Immunology
  • Infectious diseases

Background:

  • Severe infections significantly reduce T cell counts in children.
  • The prognostic significance and cytokine-mediated mechanisms of T cell depletion in pediatric critical illness are not well understood.

Purpose of the Study:

  • To investigate the association between T cell counts and mortality in critically ill children with severe infections.
  • To determine the extent to which this association is mediated by circulating cytokines.

Main Methods:

  • Prospective cohort study in a 55-bed pediatric intensive care unit (PICU).
  • Enrolled 252 children (28 days to 18 years) admitted for infections, excluding those with pre-existing conditions affecting T cells.
  • Analyzed CD3+ T cell counts, mortality rates, and cytokine mediation, including platelet-derived growth factor (PDGF)-AA.

Main Results:

  • Low T cell counts were nonlinearly associated with increased 30-, 60-, and 90-day mortality (p < 0.05).
  • A risk plateau for mortality was observed beyond 705.14 T cells/μL.
  • Low T cell count independently predicted increased mortality risk (HR 2.62 for 90-day mortality).
  • Platelet-derived growth factor (PDGF)-AA mediated 71.19% of the association between T cell count and mortality.

Conclusions:

  • Early T cell depletion is an independent predictor of mortality in critically ill children with severe infections.
  • Immune profiling in early stages of severe infections can provide prognostic value.
  • Platelet-derived growth factor (PDGF)-AA may play a significant immunoregulatory role in severe infections.
Abstract

Keywords:
T-lymphocytecytokinesintensive care unitsmortalitypediatricplatelet-derived growth factor-AA

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