Peripheral Blood CD8+T Cell as a Prognostic Biomarker for Hospitalised COVID-19 Patients Without Antiviral Treatment

Yuming Sun,1– 6,&ast; Peilin Liu,7,&ast; Lifang Zhang,8 Shaorong Lei,1 Qian Gao7 1Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2National Engineering Research Centre of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3Furong Laboratory, Central South University, Changsha, People’s Republic of China; 4Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Centre of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 5National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 6Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 7Clinical Laboratory Department, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 8Department of Plastic and Cosmetic Surgery, Changsha Mylike Cosmetic Hospital, Changsha, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qian Gao; Shaorong Lei, Email gaoqian@csu.edu.cn; leishaorong@csu.edu.cnBackground: The status of T lymphocyte subset counts in patients with COVID-19 remains uncertain. This study aimed to assess alterations in peripheral blood CD3+CD8+T (CD8+T) cells among hospitalized COVID-19 patients who have not received antiviral treatment and to evaluate their prognostic value within this patient population.Methods: A single-center, retrospective cohort study and a meta-analysis were conducted. The cohort study was performed at Xiangya Hospital from December 5, 2022, to January 31, 2023. We conducted a meta-analysis to explore the association between peripheral blood CD3+CD8+T cells and mortality in COVID-19 patients who did not receive antiviral therapy. All relevant studies in Embase, PubMed, Web of Science databases were systematically searched for meta-analysis.Results: The retrospective cohort study included 201 patients. A significant decrease in peripheral blood CD8+ T cell count was found to be associated with an increased risk of mortality (adjusted odds ratio [aOR]: 13.88; 95% confidence interval [CI]: 3.15– 61.23), after adjusting for gender, age, comorbidities, severity at admission, steroid therapy, and antibiotic therapy. The threshold value for CD8+T cell counts, determined by the receiver operating characteristic (ROC) curve analysis, was 145.5 (area under the curve [AUC]: 0.828, specificity: 90.3%, sensitivity: 72.9%, P< 0.001). Additionally, A total of 7 studies with 2765 participants were included in the meta-analysis. The meta-analysis reveals a significant association between lower CD8+ T cell counts and mortality (odds ratio [OR] = 3.543, 95% CI: 1.726 to 7.272; I2=93%).Conclusion: Peripheral blood CD8+ T cell can serve as a valuable prognostic biomarker for hospitalized patients who do not receive antiviral treatment.Keywords: peripheral blood CD3+CD8+T cell, prognostic biomarker, hospitalised COVID-19 patients