Lymphocyte subsets in haematological patients with COVID-19: Multicentre prospective study

Kalicińska, Elżbieta; Szymczak, Donata; Andrasiak, Iga; Bogucka-Fedorczuk, Aleksandra; Zińczuk, Aleksander; Szymański, Wojciech; Biernat, Monika; Rymko, Marcin; Semeńczuk, Grażyna; Jabłonowska, Paula; Rybka, Justyna; Simon, Krzysztof; Wróbel, Tomasz

doi:10.1016/j.tranon.2020.100943

Cited by 14 publications

(21 citation statements)

References 22 publications

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“…Therefore, we can speculate that not only the levels, but also the function was impaired in the critically ill COVID-19 patients. These results are comparable with our previous study, which showed decreased and dysfunctional TCRγ/δ in hematological patients with COVID-19 [ 46 ]. It is important to notice that both critically ill patients with COVID-19 as well as patients with hematological malignancies are characterized by their impaired ability to eliminate pathogens.…”

Section: Discussionsupporting

confidence: 92%

Immunosuppression as a Hallmark of Critical COVID-19: Prospective Study

Kalicińska

Szymczak

Zińczuk

et al. 2021

Cells

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The dysregulation of both the innate and adaptive responses to SARS-CoV-2 have an impact on the course of COVID-19, and play a role in the clinical outcome of the disease. Here, we performed a comprehensive analysis of peripheral blood lymphocyte subpopulations in 82 patients with COVID-19, including 31 patients with a critical course of the disease. In COVID-19 patients who required hospitalization we analyzed T cell subsets, including Treg cells, as well as TCRα/β and γ/δ, NK cells, and B cells, during the first two weeks after admission to hospital due to the SARS-CoV-2 infection, with marked reductions in leukocytes subpopulations, especially in critically ill COVID-19 patients. We showed decreased levels of Th, Ts cells, Treg cells (both naïve and induced), TCRα/β and γ/δ cells, as well as CD16+CD56+NK cells in ICU compared to non-ICU COVID-19 patients. We observed impaired function of T and NK cells in critically ill COVID-19 patients with extremely low levels of secreted cytokines. We found that the IL-2/INFγ ratio was the strongest indicator of a critical course of COVID-19, and was associated with fatal outcomes. Our findings showed markedly impaired innate and adaptive responses in critically ill COVID-19 patients, and suggest that the immunosuppressive state in the case of a critical course of SARS-CoV-2 infection might reflect subsequent clinical deterioration and predict a fatal outcome.

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Section: Discussionsupporting

confidence: 92%

Immunosuppression as a Hallmark of Critical COVID-19: Prospective Study

Kalicińska

Szymczak

Zińczuk

et al. 2021

Cells

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“…SARS-CoV-2 infection causes severe illness, particularly in certain groups of patients. Patients with hematological cancer are particularly vulnerable to an unfavorable course of COVID-19 and poor outcome [ 1 , 2 ]. Finding a reliable and accurate predictor of the course of the SARS-CoV-2 infection might be beneficial during the early clinical evaluation and treatment of COVID-19 patients as well as in reducing mortality.…”

Section: Introductionmentioning

confidence: 99%

Endothelial Activation and Stress Index (EASIX) as an Early Predictor for Mortality and Overall Survival in Hematological and Non-Hematological Patients with COVID-19: Multicenter Cohort Study

Kalicińska

Biernat

Rybka

et al. 2021

JCM

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COVID-19, as a disease involving the endothelium of multiple organs, is characterized by high mortality rates among hospitalized patients. Patients with hematological malignancies are particularly at risk of an unfavorable course of COVID-19. The endothelial activation and stress index (EASIX) score has been used as a simple predictor of overall survival (OS) in specific groups of hematological cancer patients. EASIX, as a biomarker of endothelial dysfunction, might play a prognostic role in patients with COVID-19. Here, we performed a comprehensive retrospective analysis of the EASIX score in 523 hospitalized COVID-19 patients with or without coexisting hematological cancer. Hematological cancer COVID-19 patients had higher EASIX scores compared to the overall population with COVID-19. In hematological patients, EASIX was a strong predictor of the occurrence of sepsis during COVID-19. Our findings demonstrated EASIX as a strong predictor of intensive care unit admission, in-hospital mortality, the occurrence of acute renal failure and the need for hemodialysis, both in hematological and non-hematological COVID-19 patients. Patients with a high EASIX score on COVID-19 diagnosis had significantly inferior OS compared to patients with low EASIX. We showed for the first time that EASIX might serve as a simple, universal prognostic tool of OS in both hematological and non-hematological COVID-19 patients.

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“…The decline of HLA-DR + CD8 + T cells was in parallel with reduction of EBV load (30). The upregulation of HLA-DR on CD8 + T cells was also reported in other virus infection, such as influenza, SARS, and Dengue (31)(32)(33). Therefore, effective expansion of reactive CD8 + T cells is needed for early protection against EBV infection.…”

Section: Discussionmentioning

confidence: 77%

HLA-DR Expression Level in CD8+ T Cells Correlates With the Severity of Children With Acute Infectious Mononucleosis

et al. 2021

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BackgroundThis study aimed to assess the host immune signatures associated with EBV infection and its clinical value in indicating the severity of children with acute infectious mononucleosis (IM).MethodsTwenty-eight pediatric patients with IM aged 3–8 years were enrolled. The immune phenotypes and cytokine secretion capability of T cells were detected.ResultsThe percentages and absolute numbers of CD3+ and CD8+ T cells were significantly increased in IM patients compared with HCs. The percentages of Naïve CD4+ and CD8+ T cells were decreased but with increased percentages of memory CD4+ and CD8+ T subsets. Our results showed the upregulation of active marker HLA-DR, TCR-αβ, and inhibitory receptors PD-1, TIGIT in CD8+ T cells from IM patients, which suggested that effective cytotoxic T cells were highly against EBV infection. However, EBV exposure impaired the cytokine (IFN-γ, IL-2, and TNF-α) secretion capability of CD4+ and CD8+ T cells after stimulation with PMA/ionomycin in vitro. Multivariate analysis revealed that the percentage of HLA-DR+ CD8+ T cells was an independent prognostic marker for IM. The percentage of HLA-DR+ CD8+ T cells was significantly correlated with high viral load and abnormal liver function results.ConclusionRobust expansion and upregulation of HLA-DR in CD8+ T cells, accompanied with impaired cytokine secretion, were typical characteristics of children with acute IM. The percentage of HLA-DR+ CD8+ T cells might be used as a prominent marker not only for the early diagnosis but also for indicating the severity of IM.

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Lymphocyte subsets in haematological patients with COVID-19: Multicentre prospective study

Cited by 14 publications

References 22 publications

Immunosuppression as a Hallmark of Critical COVID-19: Prospective Study

Immunosuppression as a Hallmark of Critical COVID-19: Prospective Study

Endothelial Activation and Stress Index (EASIX) as an Early Predictor for Mortality and Overall Survival in Hematological and Non-Hematological Patients with COVID-19: Multicenter Cohort Study

HLA-DR Expression Level in CD8+ T Cells Correlates With the Severity of Children With Acute Infectious Mononucleosis

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