与严重 COVID-19 后长期肺部病理和死亡相关的持续 T 细胞耗竭：来自两项挪威队列研究的结果。
Persistent T-cell exhaustion in relation to prolonged pulmonary pathology and death after severe COVID-19: Results from two Norwegian cohort studies.
机构信息
Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.
出版信息
J Intern Med. 2022 Nov;292(5):816-828. doi: 10.1111/joim.13549. Epub 2022 Aug 18.
BACKGROUND
T-cell activation is associated with an adverse outcome in COVID-19, but whether T-cell activation and exhaustion relate to persistent respiratory dysfunction and death is unknown.
OBJECTIVES
To investigate whether T-cell activation and exhaustion persist and are associated with prolonged respiratory dysfunction and death after hospitalization for COVID-19.
METHODS
Plasma and serum from two Norwegian cohorts of hospitalized patients with COVID-19 (n = 414) were analyzed for soluble (s) markers of T-cell activation (sCD25) and exhaustion (sTim-3) during hospitalization and follow-up.
RESULTS
Both markers were strongly associated with acute respiratory failure, but only sTim-3 was independently associated with 60-day mortality. Levels of sTim-3 remained elevated 3 and 12 months after hospitalization and were associated with pulmonary radiological pathology after 3 months.
CONCLUSION
Our findings suggest prolonged T-cell exhaustion is an important immunological sequela, potentially related to long-term outcomes after severe COVID-19.
背景
T 细胞激活与 COVID-19 的不良结局相关，但 T 细胞激活和耗竭是否与持续性呼吸功能障碍和死亡有关尚不清楚。
目的
研究 COVID-19 住院后 T 细胞激活和耗竭是否持续存在，并与持续性呼吸功能障碍和死亡相关。
方法
分析了来自挪威两个 COVID-19 住院患者队列（n=414）的血浆和血清中的可溶性（s）T 细胞激活（sCD25）和耗竭（sTim-3）标志物，在住院期间和随访期间进行分析。
结果
这两种标志物均与急性呼吸衰竭密切相关，但只有 sTim-3 与 60 天死亡率独立相关。sTim-3 的水平在住院后 3 个月和 12 个月仍保持升高，并与 3 个月时的肺部放射病理学相关。
结论
我们的研究结果表明，T 细胞耗竭的持续存在是一种重要的免疫后遗症，可能与严重 COVID-19 后的长期结局有关。
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