Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, No 1, Youyi Road, Chongqing, 400016, China.
Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, 400014, China.
BMC Infect Dis. 2021 Jan 12;21(1):57. doi: 10.1186/s12879-020-05741-w.
In December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei, China. Moreover, it has become a global pandemic. This is of great value in describing the clinical symptoms of COVID-19 patients in detail and looking for markers which are significant to predict the prognosis of COVID-19 patients.
In this multicenter, retrospective study, 476 patients with COVID-19 were enrolled from a consecutive series. After screening, a total of 395 patients were included in this study. All-cause death was the primary endpoint. All patients were followed up from admission till discharge or death.
The main symptoms observed in the study included fever on admission, cough, fatigue, and shortness of breath. The most common comorbidities were hypertension and diabetes mellitus. Patients with lower CD4T cell level were older and more often male compared to those with higher CD4T cell level. Reduced CD8T cell level was an indicator of the severity of COVID-19. Both decreased CD4T [HR:13.659; 95%CI: 3.235-57.671] and CD8T [HR: 10.883; 95%CI: 3.277-36.145] cell levels were associated with in-hospital death in COVID-19 patients, but only the decrease of CD4T cell level was an independent predictor of in-hospital death in COVID-19 patients.
Reductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe cases of COVID-19. It was the CD8T cell level, not the CD4T cell level, that reflected the severity of the patient's disease. Only reduced CD4T cell level was independently associated with increased in-hospital death in COVID-19 patients.
Prognostic Factors of Patients With COVID-19, NCT04292964 . Registered 03 March 2020. Retrospectively registered.
2019 年 12 月，由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）在中国湖北武汉出现。此外，它已成为全球大流行。这对于详细描述 COVID-19 患者的临床症状并寻找对预测 COVID-19 患者预后有意义的标志物具有重要价值。
在这项多中心回顾性研究中，连续纳入了 476 例 COVID-19 患者。经过筛选，共有 395 例患者纳入本研究。全因死亡是主要终点。所有患者从入院到出院或死亡进行随访。
研究中观察到的主要症状包括入院时发热、咳嗽、乏力和呼吸急促。最常见的合并症是高血压和糖尿病。与 CD4T 细胞水平较高的患者相比，CD4T 细胞水平较低的患者年龄更大，且更常为男性。CD8T 细胞水平降低是 COVID-19 严重程度的指标。CD4T[HR：13.659；95%CI：3.235-57.671]和 CD8T[HR：10.883；95%CI：3.277-36.145]细胞水平降低均与 COVID-19 患者住院期间死亡相关，但只有 CD4T 细胞水平降低是 COVID-19 患者住院期间死亡的独立预测因素。
淋巴细胞和淋巴细胞亚群减少在 COVID-19 患者中很常见，尤其是在 COVID-19 重症患者中。反映患者疾病严重程度的是 CD8T 细胞水平，而不是 CD4T 细胞水平。只有降低的 CD4T 细胞水平与 COVID-19 患者住院期间死亡风险增加独立相关。
COVID-19 患者预后因素，NCT04292964。于 2020 年 3 月 3 日注册。回顾性注册。
