Time-course analysis reveals that corticosteroids resuscitate diminished CD8+ T cells in COVID-19: a retrospective cohort study

Abstract

Objective To illustrate the effect of corticosteroids and heparin, respectively, on coronavirus disease 2019 (COVID-19) patients’ CD8+ T cells and D-dimer. Methods In this retrospective cohort study involving 866 participants diagnosed with COVID-19, patients were grouped by severity. Generalized additive models were established to explore the time-course association of representative parameters of coagulation, inflammation and immunity. Segmented regression was performed to examine the influence of corticosteroids and heparin upon CD8+ T cell and D-dimer, respectively. Results There were 541 moderate, 169 severe and 156 critically ill patients involved in the study. Synchronous changes of levels of NLR, D-dimer and CD8+ T cell in critically ill patients were observed. Administration of methylprednisolone before 14 DFS compared with those after 14 DFS ( β = 0.154%, 95% CI=(0, 0.302), p =.048) or a dose lower than 40 mg per day compared with those equals to 40 mg per day ( β = 0.163%, 95% CI=(0.027, 0.295), p =.020) significantly increased the rising rate of CD8+ T cell in 14–56 DFS. Conclusions The parameters of coagulation, inflammation and immunity were longitudinally correlated, and an early low-dose corticosteroid treatment accelerated the regaining of CD8+ T cell to help battle against SARS-Cov-2 in critical cases of COVID-19.

A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor

“… Wu et al, 2017 ) and an increased risk of avascular necrosis ( Sing, Tan, Wong, Cheung, & Cheung, 2020 ) in recovered SARS-CoV patients. During the recent COVID-19 outbreak, methylprednisolone therapies reportedly improved the clinical prognosis ( Y. Wang, W. Jiang et al, 2020 ; F. Ye et al, 2020 ) or decreased the mortality rate in COVID-19 patients ( Salton et al, 2020 ). Additional recent studies report that early, but not late phase ( Mongardon et al, 2020 ), low-dose corticosteroids decrease mortality and improve COVID-19 clinical outcomes ( Ji et al, 2020 ).…”

Different treatment response to systemic corticosteroids according to white blood cell counts in severe COVID-19 patients

“…Systemic corticosteroids are reported to increase lymphocyte counts in clinically responsive COVID-19 patients [ 22 ]. Immunomodulating effect of systemic corticosteroids may recover T-cell dysregulation and or alleviate the inflammatory process [ 23 , 24 ].…”

Persistence of Abnormal Inflammatory and Coagulation Laboratory Tests in Critically-ill COVID-19 Survivors: Case Series

“…Several follow-up studies about COVID-19 have been conducted with various time-scales ranging from 14 to 60 days, in which dynamic changes of inflammatory and coagulation variables were analysed, and risk factors for organ dysfunction, severity and mortality were evaluated (15)(16)(17)(18)(19)(20)(21)(22). Mandal et al (19) analysed long term consequences of COVID-19 in aspect of physical and psychological symptom burden, recovery of blood biomarkers and imaging in 384 patients for a median follow-up of 54 days after discharge.…”