CD4⁺ T cells related to disease severity in elderly and frailty community‐acquired pneumonia patients: A retrospective cohort study

Abstract

BackgroundsElderly and frailty individuals show a more senescent immune system, which may relate to worse outcome in community‐acquired pneumonia (CAP). This study aimed to explore prognostic factors related to immune.MethodsSixty of elderly (≥65 years) and frailty (clinical frailty scale ≥5 scores) nonsevere CAP patients and 60 severe CAP (SCAP) patients were recruited at our center. Clinical and laboratory data, and several assessment scores were collected.ResultsCompared with nonsevere CAP group, the elderly and frailty SCAP patients showed higher level of BMI, PaCO2 and lactate in arterial blood‐gas, CURB‐65 score, ICU admission, mechanical ventilation, shock accidence, and longer hospital stay using two‐tailed t test. The SCAP group also showed increased CRP, IL‐6, and PCT, and decreased CD3+ T cells, CD4+ T cells, and CD8+ T cells. Logistic regression analysis showed that CD4+ T cells, IL‐6 and PCT were independent prognostic factors for SCAP. The area under the receiver operating characteristic (ROC) curve for CD4+ T cells combined with PCT was 0.771 (95% CI 0.683–0.859), and the sensitivity and specificity were both 76.7%. Paired t test analysis showed that low CD4+ T cells in SCAP patients increased after treatment.ConclusionsCD4+ T cells decreased in elderly and frailty SCAP patients, and CD4+ T cells combined with PCT were relatively accurate in the prediction of elderly and frailty SCAP.

An explainable machine learning-based model to predict intensive care unit admission among patients with community-acquired pneumonia and connective tissue disease

“…Meanwhile, it demonstrated that in various subsets of lymphocyte, low CD4 + T cell was mainly related to ICU admission in patients with CAP and CTD. Wang et al also demonstrated CD4 + T cells (HR: 0.986, 95%CI: 0.978–0.994), rather than CD8 + T cell, was an independent risk factor for severe CAP in elderly and frailty patients [ 45 ]. CRP, a widely utilized inflammatory biomarker, is known to be associated with the severity and mortality of CAP.…”

Efficacy of budesonide/formoterol inhalation powder in treating viral pneumonia in children

“…There has been extensive research on proinflammatory factors such as interleukin (IL)-6 and C-reactive protein (CRP)[ 8 ]. Research has shown that imbalanced regulation of cellular immune function is an important influencing factor in inflammatory reactions, and the most significant manifestation of this imbalance is in the disproportion of CD4 + T lymphocyte subgroups[ 9 ]. Budesonide/formoterol inhalation powder is a long-acting β2-adrenergic agonist (LABA)/inhaled corticosteroid (ICS) combination formulation[ 10 ].…”