Time-course analysis reveals that corticosteroids resuscitate diminished CD8+ T cells in COVID-19: a retrospective cohort study.

Abstract

OBJECTIVE:

To illustrate the effect of corticosteroids and heparin, respectively, on coronavirus disease 2019 (COVID-19) patients' CD8+ T cells and D-dimer.

METHODS:

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.

RESULTS:

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 (β = 0.154%, 95% CI=(0, 0.302), p=.048) or a dose lower than 40 mg per day compared with those equals to 40 mg per day (β = 0.163%, 95% CI=(0.027, 0.295), p=.020) significantly increased the rising rate of CD8+ T cell in 14-56 DFS.

CONCLUSIONS:

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.

• Authors: Fangzhou Ye, Jing Liu, Liangkai Chen, Bin Zhu, Li Yu, Boyun Liang, Ling Xu, Sumeng Li, Sihong Lu, Lei Fan, Dongliang Yang, Xin Zheng
• Journal: Annals of medicine (Ann Med) Vol. 53 Issue 1 Pg. 181-188 (12 2021) ISSN: 1365-2060 [Electronic] England
• PMID: 33183091 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Fibrin Fibrinogen Degradation Products
• Glucocorticoids
• fibrin fragment D
• Heparin
• Methylprednisolone

Topics

• Adult
• Aged
• Aged, 80 and over
• Blood Coagulation (drug effects, immunology)
• CD8-Positive T-Lymphocytes (drug effects, immunology)
• COVID-19 (blood, diagnosis, immunology)
• Dose-Response Relationship, Drug
• Female
• Fibrin Fibrinogen Degradation Products (analysis, immunology)
• Glucocorticoids (administration & dosage)
• Heparin (administration & dosage)
• Humans
• Inflammation (blood, diagnosis, drug therapy, immunology)
• Linear Models
• Longitudinal Studies
• Lymphocyte Count
• Male
• Methylprednisolone (administration & dosage)
• Middle Aged
• Models, Biological
• Retrospective Studies
• SARS-CoV-2 (immunology, isolation & purification)
• Severity of Illness Index
• Time Factors
• Time-to-Treatment
• Young Adult
• COVID-19 Drug Treatment