Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology, Wuhan, China.
Ann Med. 2021 Dec;53(1):181-188. doi: 10.1080/07853890.2020.1851394.
To illustrate the effect of corticosteroids and heparin, respectively, on coronavirus disease 2019 (COVID-19) patients' CD8+ T cells and D-dimer.
In this retrospective cohort study involving 866 participants diagnosed with COVID-19, patients were grouped by severity. Generalized additive models were established to explore the time-course association of representative parameters of coagulation, inflammation and immunity. Segmented regression was performed to examine the influence of corticosteroids and heparin upon CD8+ T cell and D-dimer, respectively.
There were 541 moderate, 169 severe and 156 critically ill patients involved in the study. Synchronous changes of levels of NLR, D-dimer and CD8+ T cell in critically ill patients were observed. Administration of methylprednisolone before 14 DFS compared with those after 14 DFS ( = 0.154%, 95% CI=(0, 0.302), =.048) or a dose lower than 40 mg per day compared with those equals to 40 mg per day ( = 0.163%, 95% CI=(0.027, 0.295), =.020) significantly increased the rising rate of CD8+ T cell in 14-56 DFS.
The parameters of coagulation, inflammation and immunity were longitudinally correlated, and an early low-dose corticosteroid treatment accelerated the regaining of CD8+ T cell to help battle against SARS-Cov-2 in critical cases of COVID-19.
分别阐述皮质类固醇和肝素对 2019 年冠状病毒病（COVID-19）患者 CD8+T 细胞和 D-二聚体的影响。
本回顾性队列研究纳入了 866 例确诊 COVID-19 的患者，根据病情严重程度进行分组。建立广义加性模型，以探讨凝血、炎症和免疫的代表性参数的时间相关性。进行分段回归，以分别研究皮质类固醇和肝素对 CD8+T 细胞和 D-二聚体的影响。
本研究纳入了 541 例中度、169 例重度和 156 例危重症患者。危重症患者的 NLR、D-二聚体和 CD8+T 细胞水平同步变化。与 14 天无死亡间隔（DFS）后相比，在 14 天 DFS 前（=0.154%，95%CI（0，0.302），=0.048）或日剂量低于 40mg 时相比，日剂量等于 40mg（=0.163%，95%CI（0.027，0.295），=0.020）皮质类固醇治疗明显增加了 14-56 天 DFS 期间 CD8+T 细胞的上升率。
凝血、炎症和免疫参数呈纵向相关，早期低剂量皮质类固醇治疗可加速 CD8+T 细胞的恢复，有助于对抗 COVID-19 危重症患者中的 SARS-CoV-2。
