NKG2A Expression among CD8 Cells Is Associated with COVID-19 Progression in Hypertensive Patients: Insights from the BRACE CORONA Randomized Trial.
Renata Moll-BernardesSérgio C FortierAndréa S SousaRenato D LopesNarendra VeraLuciana CondeAndré FeldmanGuilherme ArrudaMauro Jorge Cabral-CastroDenílson C AlbuquerqueThiago C PaulaThyago FurquimVitor A LouresKarla GiustiNathália OliveiraAriane MacedoPedro Gabriel Melo de Barros E SilvaFábio De LucaMarisol KotsugaiRafael DomicianoFlávia A SilvaMayara F SantosOlga F SouzaFernando Luiz Cyrino OliveiraRonir Raggio LuizEmiliano MedeiPublished in: Journal of clinical medicine (2022)
Cardiovascular comorbidities and immune-response dysregulation are associated with COVID-19 severity. We aimed to explore the key immune cell profile and understand its association with disease progression in 156 patients with hypertension that were hospitalized due to COVID-19. The primary outcome was progression to severe disease. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and immune cell subsets associated with the primary outcome. Obesity; diabetes; oxygen saturation; lung involvement on computed tomography (CT) examination; the C-reactive protein concentration; total lymphocyte count; proportions of CD4+ and CD8+ T cells; CD4/CD8 ratio; CD8+ HLA-DR MFI; and CD8+ NKG2A MFI on admission were all associated with progression to severe COVID-19. This study demonstrated that increased CD8+ NKG2A MFI at hospital admission, in combination with some clinical variables, is associated with a high risk of COVID-19 progression in hypertensive patients. These findings reinforce the hypothesis of the functional exhaustion of T cells with the increased expression of NKG2A in patients with severe COVID-19, elucidating how severe acute respiratory syndrome coronavirus 2 infection may break down the innate antiviral immune response at an early stage of the disease, with future potential therapeutic implications.
Keyphrases
- coronavirus disease
- sars cov
- respiratory syndrome coronavirus
- nk cells
- immune response
- hypertensive patients
- blood pressure
- computed tomography
- early stage
- poor prognosis
- type diabetes
- early onset
- emergency department
- peripheral blood
- positron emission tomography
- natural killer cells
- insulin resistance
- long non coding rna
- induced apoptosis
- metabolic syndrome
- healthcare
- oxidative stress
- radiation therapy
- dual energy
- skeletal muscle
- inflammatory response
- sentinel lymph node
- cell cycle arrest
- lymph node
- adverse drug