Association of follicular helper T and follicular regulatory T cells with severity and hyperglycemia in hospitalized COVID-19 patients

• Published in: Virulence Vol. 13; no. 1; pp. 569 - 577
• Main Authors: Zahran, Asmaa M., Abdel-Rahim, Mona H., Nasif, Khalid A., Hussein, Safinaz, Hafez, Rania, Ahmad, Ahmad Bahieldeen, Saad, Khaled, Elhoufey, Amira, Hussein, Hosni A. M., Thabet, Ali A., El-Badawy, Omnia
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 31.12.2022; Taylor & Francis Group
• Subjects: CD4-Positive T-Lymphocytes; COVID-19; follicular helper T; follicular regulatory T; Humans; Hyperglycemia; Research Paper; SARS-CoV-2; T-Lymphocytes, Regulatory; COVID-19; hyperglycemia; follicular helper T; follicular regulatory T
• ISSN: 2150-5594; 2150-5608
• DOI: 10.1080/21505594.2022.2047506

We aimed to determine the levels of follicular helper T (Tfh) and follicular regulatory T (Tfr) cells in COVID-19 patients and determine whether their levels correlated with disease severity and presence of hyperglycemia. This study was carried out in 34 hospitalized COVID-19 patients and 20 healthy controls. Levels of total circulating Tfh, inducible T-cell costimulator (ICOS)+ activated Tfh, and Tfr cells were assessed in all participants by flow cytometry. Total CD4+CXCR5+ Tfh cells and ICOS+Foxp3-activated Tfh cells increased and ICOS+Foxp3+ Tfr cells decreased in COVID-19 patients, especially in diabetic patients and those with severe disease. Activated ICOS+ Tfh cells were directly correlated with lactate dehydrogenase, D-dimer, ferritin, and respiratory rate and inversely correlated with the partial pressure of carbon dioxide. COVID-19 is associated with marked activation of Tfh cells and a profound drop in Tfr cells, especially in severe and diabetic patients. Future studies on expanded cohorts of patients are needed to clarify the relationship between SARS-CoV-2 and acute-onset diabetes.