Original article
T-cell immune response predicts the risk of critical SARS-Cov2 infection in hospitalized COVID-19 patients

https://doi.org/10.1016/j.ejim.2022.06.001Get rights and content

Highlights

  • Th17 cells are increased in patients who progress to critical Covid-19.

  • In severe Covid-19, Th17>0.435% of CD4 t cells is associated with poorer survival.

Assessment of Th17 cells could help target patients in need of anti-IL6R therapy.

Abstract

Introduction

This study aimed to identify markers of disease worsening in patients hospitalized for SARS-Cov2 infection.

Patients and methods

Patients hospitalized for severe recent-onset (<1 week) SARS-Cov2 infection were prospectively included. The percentage of T-cell subsets and plasma IL-6 at admission (before any steroid therapy) were compared between patients who progressed to a critical infection and those who did not.

Results

Thirty-seven patients (18 men, 19 women) were included; 11 (30%) progressed to critical infection. At admission, the critical infection patients were older (P = 0.021), had higher creatinine levels (P = 0.003), and decreased percentages of circulating B cells (P = 0.04), T cells (P = 0.009), and CD4+ T cells (P = 0.004) than those with a favorable course. Among T cell subsets, there was no significant difference between the two groups except for the percentage of Th17 cells, which was two-fold higher in patients who progressed to critical infection (P = 0.028). Plasma IL-6 at admission was also higher in this group (P = 0.018). In multivariate analysis, the percentage of circulating Th17 cells at admission was the only variable associated with higher risk of progression to critical SARS-Cov2 infection (P = 0.021).

Conclusion

This study suggests that an elevated percentage of Th17 cells in patients hospitalized for SARS-Cov2 infection is associated with an increased risk of progression to critical disease. If these data are confirmed in a larger study, this marker could be used to better target the population of patients in whom tocilizumab could decrease the risk of progression to critical COVID-19.

Keywords

SARS Cov2
Covid-19
Th17 cells
IL-6

Cited by (0)

1

Bernard BONNOTTE: Roche-Chugaï, Boerhinger Ingelheim and Novartis (remuneration for symposiums and consulting payments).

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