T Cells Immunophenotyping and CD38 Overexpression as Hallmarks of the Severity of COVID-19 and Predictors of Patients' Outcomes

• Published in: Journal of clinical medicine Vol. 12; no. 2; p. 710
• Main Authors: Tarbiah, Nesrin I, Alkhattabi, Nuha A, Alsahafi, Abdullah J, Aljahdali, Hani S, Joharjy, Husam M, Al-Zahrani, Maryam H, Sabban, Aliaa M, Alghamdi, Rana A, Balgoon, Maha J, Khalifa, Reham A
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 16.01.2023; MDPI
• Subjects: Cell adhesion & migration; Clinical medicine; Coronaviruses; COVID-19; Cytokine storm; Enzymes; Hematology; Hospitals; Infections; Laboratories; Lymphocytes; Medical records; Neutrophils; Pandemics; Pathogenesis; Pathogens; Patients; Pneumonia; Severe acute respiratory syndrome coronavirus 2; Thrombosis; Ventilators; Viral infections; COVID-19; CD38; T-cytotoxic (CD8+); T cells; T-helper (CD4+)
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12020710

By the end of 2019, the COVID-19 pandemic spread all around the world with a wide spectrum of clinical presentations ranging from mild to moderate to severe or critical cases. T cell subtype dysregulation is mostly involved in the immunopathogenic mechanism. The present study aimed to highlight the role of monitoring T cell subtypes and their activation (expression of CD38) in COVID-19 patients compared to healthy subjects and their role in predicting severity and patients' outcomes. The study involved 70 adult COVID-19 confirmed cases stratified into three groups: a mild/asymptomatic group, a clinically moderate group, and a clinically severe/critical group. Flow cytometry analysis was used for the assessment of CD3 cells for total T cell count, CD4 cells for helper T cells (Th), CD8 cells for cytotoxic T cells (Tc), CD4 CD25 cells for regulatory T cells (T reg), and CD38 expression in CD4 T cells and CD8 T cells for T cell activation. A statistically significant difference was found between COVID-19 cases and healthy controls as regards low counts of all the targeted T cell subtypes, with the lowest counts detected among patients of the severe/critical group. Furthermore, CD38 overexpression was observed in both CD4 and CD8 T cells. Decreased T cell count, specifically CD8 T cell (Tc), with T cell overactivation which was indicated by CD38 overexpression on CD4 and CD8 T cells had a substantial prognostic role in predicting severity and mortality among COVID-19 patients. These findings can provide a preliminary tool for clinicians to identify high-risk patients requiring vigilant monitoring, customized supportive therapy, or ICU admission. Studies on larger patient groups are needed.