Qiu Meihua, Song Xiaogang, Zhang Qianqian, Zou Shenchun, Pang Lingling, Nian Xueyuan
Department of Respiratory and Critical Care Medicine, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China.
Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Immunol. 2024 Nov 25;15:1465238. doi: 10.3389/fimmu.2024.1465238. eCollection 2024.
Little is known about immunophenotyping characteristics and clinical outcomes of COVID-19 patients treated with azvudine during the Omicron variant surge.
This study enrolled patients diagnosed with COVID-19 from December 2022 to February 2023. The primary outcome was defined as all-cause mortality, along with a composite outcome reflecting disease progression. The enrolled patients were followed for a period of 60 days from their admission.
A total of 268 COVID-19 patients treated with azvudine were enrolled in this retrospective study. The study found that the counts of lymphocyte subsets were significantly reduced in the composite outcome and all-cause mortality groups compared to the non-composite outcome and discharge groups (all < 0.001). Correlation analysis revealed a negative association between lymphocyte subsets cell counts and inflammatory markers levels. The receiver operating characteristic (ROC) curve analysis identified low CD4 T cell count as the most significant predictor of disease progression and all-cause mortality among the various lymphocyte subsets. Additionally, both the Kaplan-Meier curve and multivariate regression analysis demonstrated that low CD4 T cell count level (< 156.00 cells/μl) was closely associated with all-cause mortality in COVID-19 patients treated with azvudine.
A low CD4 T cell count may serve as a significant predictive indicator for identifying COVID-19 patients receiving azvudine treatment who are at an elevated risk of experiencing adverse outcomes. These findings may offer valuable insights for physicians in optimizing the administration of azvudine.
关于在奥密克戎变异株激增期间接受阿兹夫定治疗的新冠病毒疾病（COVID-19）患者的免疫表型特征和临床结局，目前所知甚少。
本研究纳入了2022年12月至2023年2月期间确诊为COVID-19的患者。主要结局定义为全因死亡率，以及反映疾病进展的综合结局。纳入的患者从入院起随访60天。
本项回顾性研究共纳入了268例接受阿兹夫定治疗的COVID-19患者。研究发现，与非综合结局组和出院组相比，综合结局组和全因死亡率组的淋巴细胞亚群计数显著降低（均P<0.001）。相关性分析显示淋巴细胞亚群细胞计数与炎症标志物水平之间呈负相关。受试者工作特征（ROC）曲线分析确定，在各种淋巴细胞亚群中，低CD4 T细胞计数是疾病进展和全因死亡率的最显著预测指标。此外，Kaplan-Meier曲线和多因素回归分析均表明，低CD4 T细胞计数水平（<156.00个细胞/μl）与接受阿兹夫定治疗的COVID-19患者的全因死亡率密切相关。
低CD4 T细胞计数可能是识别接受阿兹夫定治疗且发生不良结局风险较高的COVID-19患者的重要预测指标。这些发现可能为医生优化阿兹夫定的用药提供有价值的见解。
