BackgroundCellular immunodeficiency and comorbidities are common in COVID-19 patients.AimThe purpose of this study was to investigate comorbidities impacting on the cellular immunity in COVID-19 patients.MethodsThe research objects included 55 healthy controls and 718 COVID-19 patients who divided into the control group and the COVID-19 group, respectively. Those in the COVID-19 group were divided into subgroups on the basis of the number and types of comorbidities present. Lymphocyte itself and its subsets were compared between the control group and the COVID-19 group, the groups with comorbidities based on the different number and types of comorbidities, and the relationship between the lymphocyte counts and subsets with the number and types of comorbidities was investigated.ResultsCompared with the control group, the lymphocyte counts and T cell subsets were significantly increased in the groups with comorbidities, but both B and NK cell subsets were significantly decreased in the no comorbidity group and in most of the groups with comorbidities (all P<0.05). In the three comorbidities group, the lymphocyte counts and T cell subsets were all significantly decreased, but the CD56+ percentage was obviously increased (all P<0.05). The number of comorbidities was negatively correlated with the lymphocyte counts and the T and NK cell subsets. A negative correlation also existed between cancer and both the lymphocyte counts and the T cell subsets, between chronic hepatitis B and the lymphocyte counts, and between chronic kidney disease and the CD3+ counts. A positive correlation existed between nonalcoholic fatty liver disease (NAFLD) disease and both lymphocyte and CD3+ counts. The risk factors were number of comorbidities for the lymphocyte count, CD3+CD4+ and CD3+CD8+ percentages, NAFLD for the lymphocyte and CD3+ counts, cardiovascular diseases for CD3+CD4+ and CD3+CD8+ percentages, diabetes mellitus for the CD3+CD8+ percentage, and cancer for the CD3+ percentage, respectively.ConclusionsHigh numbers of comorbidities and specific comorbidities could impact the immune response of COVID-19 patients. This study provides a reference for clinicians in the identification of suitable and timely immunotherapy for COVID-19 patients.Clinical Trial Registryhttps://www.chictr.org.cn/enindex.aspx, identifier ChiCTR2000034563.
BackgroundOrganism can lead to excessive nutrient consumption in the infected state and increase nutritional risk, which is detrimental to the control of the infection and can further aggravate the disease.ObjectivesTo investigate the impact of nutritional risk and the NRS2002 score on disease progression and prognosis in patients with COVID-19.MethodsThis was a retrospective cohort study including 1,228 COVID-19 patients, who were divided into a with-nutritional risk group (patients with NRS2002 score ≥ 3) and a without-nutritional risk group (patients with NRS2002 score < 3) according to the NRS2002 score at admission. The differences in clinical and outcome data between the two groups were compared, and the relationship between the NRS2002 score and the disease progression and prognosis of COVID-19 patients was assessed.ResultsOf 1,228 COVID-19 patients, including 44 critical illness patients and 1,184 non-critical illness patients, the rate of harboring nutritional risk was 7.90%. Compared with those in the without-nutritional risk group, patients in the with-nutritional risk group had a significantly longer coronavirus negative conversion time, significantly lower serum albumin (ALB), total serum protein (TP) and hemoglobin (HGB) at admission, discharge or 2 weeks, a significantly greater proportion with 3 or more comorbidities, and a significantly higher rate of critical illness and mortality (all p < 0.001). Multiple regression analysis showed that nutritional risk, NRS2002 score and ALB at admission were risk factors for disease severity. In addition, nutritional risk, NRS2002 score and TP at admission were risk factors for prognosis. The NRS2002 score showed the best utility for predicting critical illness and death in COVID-19 patients.ConclusionNutritional risk and a high NRS2002 score are closely related to disease progression and poor prognosis in COVID-19 patients. For patients with NRS2002 score > 0.5, early intervention of malnutrition is needed to reduce the occurrence of critical disease. Additionally, for patients with NRS2002 score > 5.5, continuous nutritional support therapy is needs to reduce mortality and improve prognosis.Clinical Trial registration: [https://www.chictr.org.cn/historyversionpub.aspx?regno=ChiCTR2000034563], identifier [Chinese Clinical Trial Register ChiCTR2000034563].
Objectives: To investigate the relationship between nutritional risk and Nutritional Risk Screening 2002 (NRS2002) score with disease progression and prognosis in patients with COVID-19. Methods: The NRS2002 score of 1228 COVID-19 patients were retrospective analyzed, they were divided into with-nutritional risk group (NRS2002 score≥3) and without-nutritional risk group (NRS2002 score<3) according to the NRS2002 score at admission. To compare the differences between the two groups in clinical and outcome data and assess the relationship between the NRS2002 score and the disease progression and prognosis of COVID-19 patients. Results: Of 1228 COVID-19 patients, the nutritional risk rate was 7.90%. Compared with those in without-nutritional risk group, patients in with-nutritional risk group had significantly longer the coronavirus negative conversion time, obviously lower albumin (ALB), total protein (TP) and hemoglobin (HGB), obviously greater proportion with 3 or more comorbidities, and significantly higher rate of critical illness and mortality (P<0.01). Regression analysis showed that with nutritional risk, NRS2002 score and ALB were the risk factors for disease severity, and with nutritional risk, NRS2002 score and TP were the risk factors for prognosis. The NRS2002 score showed the best utility for predicting critical and dead COVID-19 patients. Conclusions: With nutritional risk and high NRS2002 score are closely related to disease progression and poor prognosis in COVID-19 patients. For patients with NRS2002 score >0.5, early intervention of malnutrition is needed to reduce the occurrence of critical disease. And for patients with NRS2002 score >5.5, continuous nutritional support therapy is needs to reduce mortality and improve prognosis. Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563
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