Individuals With Higher CD4/CD8 Ratio Exhibit Increased Risk of Acute Respiratory Distress Syndrome and In-Hospital Mortality During Acute SARS-CoV-2 Infection Article Swipe
Ana Pascual‐Dapena
,
Juan J. Chillarón
,
Gemma Llauradó
,
Isabel Arnau-Barrés
,
Juana M. Flores
,
Inmaculada López-Montesinos
,
Luisa Sorlí
,
Juan Luis Martínez-Pérez
,
Sílvia Gómez-Zorrilla
,
Juan Du
,
Natàlia Garcia‐Giralt
,
Robert Güerri‐Fernández
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/fmed.2022.924267
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/fmed.2022.924267
Background CD4/CD8 ratio has been used as a quantitative prognostic risk factor in patients with viral infections. This study aims to assess the association between in-hospital mortality and at admission CD4/CD8 ratio among individuals with acute SARS-CoV-2 infection. Methods This is a longitudinal cohort study with data of all consecutive patients admitted to the COVID-19 unit at Hospital del Mar, Barcelona, Spain for ≥48 h between March to May 2020. The CD4+ CD8+ T-cell subset differentiation was assessed by flow cytometry at admission as well as a complete blood test. Patients were classified according to CD4/CD8 ratio tertiles. The primary outcome was in-hospital mortality and the secondary outcome was acute respiratory distress (ARDS). Results A total of 338 patients were included in the cohort. A high CD4/CD8 ratio (third tertile) was associated with a higher in-hospital mortality [adjusted Cox model hazard ratio (HR) 4.68 (95%CI 1.56–14.04, p = 0.006), reference: second tertile HR 1]. Similarly, a high CD4/CD8 ratio (third tertile) was associated with a higher incidence of ARDS [adjusted logistic regression model OR 1.97 (95%CI 1.11–3.55, p = 0.022) reference: second tertile HR 1]. There was a trend of higher in-hospital mortality and incidence of ARDS in patients within the first tertile of CD4/CD8 ratio compared with the second one, but the difference was not significant. No associations were found with total lymphocyte count or inflammatory parameters, including D-dimer. Conclusion CD4/CD8 ratio is a prognostic factor for the severity of COVID-19, reflecting the negative impact on prognosis of those individuals whose immune response has abnormal CD8+ T-cell expansion during the early response to the infection.
Related Topics
Concepts
Medicine
ARDS
Hazard ratio
Incidence (geometry)
Internal medicine
CD4-CD8 Ratio
Proportional hazards model
CD8
Confidence interval
Immunology
Lung
Lymphocyte subsets
Immune system
Physics
Optics
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fmed.2022.924267
- https://www.frontiersin.org/articles/10.3389/fmed.2022.924267/pdf
- OA Status
- gold
- Cited By
- 22
- References
- 32
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4283328345
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4283328345Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3389/fmed.2022.924267Digital Object Identifier
- Title
-
Individuals With Higher CD4/CD8 Ratio Exhibit Increased Risk of Acute Respiratory Distress Syndrome and In-Hospital Mortality During Acute SARS-CoV-2 InfectionWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-06-23Full publication date if available
- Authors
-
Ana Pascual‐Dapena, Juan J. Chillarón, Gemma Llauradó, Isabel Arnau-Barrés, Juana M. Flores, Inmaculada López-Montesinos, Luisa Sorlí, Juan Luis Martínez-Pérez, Sílvia Gómez-Zorrilla, Juan Du, Natàlia Garcia‐Giralt, Robert Güerri‐FernándezList of authors in order
- Landing page
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https://doi.org/10.3389/fmed.2022.924267Publisher landing page
- PDF URL
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https://www.frontiersin.org/articles/10.3389/fmed.2022.924267/pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://www.frontiersin.org/articles/10.3389/fmed.2022.924267/pdfDirect OA link when available
- Concepts
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Medicine, ARDS, Hazard ratio, Incidence (geometry), Internal medicine, CD4-CD8 Ratio, Proportional hazards model, CD8, Confidence interval, Immunology, Lung, Lymphocyte subsets, Immune system, Physics, OpticsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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22Total citation count in OpenAlex
- Citations by year (recent)
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2025: 9, 2024: 7, 2023: 6Per-year citation counts (last 5 years)
- References (count)
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32Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.≥48 | 63 |
| abstract_inverted_index.(95%CI | 144, 175 |
| abstract_inverted_index.(third | 128, 159 |
| abstract_inverted_index.0.022) | 179 |
| abstract_inverted_index.T-cell | 73, 257 |
| abstract_inverted_index.assess | 21 |
| abstract_inverted_index.cohort | 43 |
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| abstract_inverted_index.second | 150, 181, 209 |
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| abstract_inverted_index.within | 199 |
| abstract_inverted_index.(ARDS). | 112 |
| abstract_inverted_index.0.006), | 148 |
| abstract_inverted_index.CD4/CD8 | 1, 30, 95, 126, 157, 204, 231 |
| abstract_inverted_index.Methods | 38 |
| abstract_inverted_index.Results | 113 |
| abstract_inverted_index.between | 24, 65 |
| abstract_inverted_index.cohort. | 123 |
| abstract_inverted_index.outcome | 100, 107 |
| abstract_inverted_index.primary | 99 |
| abstract_inverted_index.tertile | 151, 182, 202 |
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| abstract_inverted_index.abnormal | 255 |
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| abstract_inverted_index.complete | 87 |
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| abstract_inverted_index.included | 120 |
| abstract_inverted_index.logistic | 170 |
| abstract_inverted_index.negative | 244 |
| abstract_inverted_index.patients | 13, 50, 118, 198 |
| abstract_inverted_index.response | 253, 262 |
| abstract_inverted_index.severity | 239 |
| abstract_inverted_index.tertile) | 129, 160 |
| abstract_inverted_index.COVID-19, | 241 |
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| abstract_inverted_index.according | 93 |
| abstract_inverted_index.admission | 29, 82 |
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| abstract_inverted_index.expansion | 258 |
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| corresponding_author_ids | https://openalex.org/A5041144467 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 12 |
| corresponding_institution_ids | https://openalex.org/I170486558, https://openalex.org/I2801357902, https://openalex.org/I4210115082, https://openalex.org/I4210130874 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8999999761581421 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.90208682 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |