Publication details

High CD4-to-CD8 ratio identifies an at-risk population susceptible to lethal COVID-19


ZUANI DE Marco LÁZNIČKOVÁ Petra TOMÁŠKOVÁ Veronika DVONČOVÁ Martina FORTE Giancarlo STOKIN Gorazd Bernard ŠRÁMEK Vladimír HELÁN Martin FRIČ Jan

Year of publication 2022
Type Article in Periodical
Magazine / Source Scandinavian journal of immunology
MU Faculty or unit

Faculty of Medicine

Keywords CD4-to-CD8 ratio; COVID-19; Intensive care unit; SARS-CoV-2; T cells; TEMRA
Description Around half of people with severe COVID-19 requiring intensive care unit (ICU) treatment will survive, but it is unclear how the immune response to SARS-CoV-2 differs between ICU patients that recover and those that do not. We conducted whole-blood immunophenotyping of COVID-19 patients upon admission to ICU and during their treatment and uncovered marked differences in their circulating immune cell subsets. At admission, patients who later succumbed to COVID-19 had significantly lower frequencies of all memory CD8+ T cell subsets, resulting in increased CD4-to-CD8 T cell and neutrophil-to-CD8 T cell ratios. ROC and Kaplan-Meier analyses demonstrated that both CD4-to-CD8 and neutrophil-to-CD8 ratios at admission were strong predictors of in-ICU mortality. Therefore, we propose the use of the CD4-to-CD8 T cell ratio as a marker for the early identification of those individuals likely to require enhanced monitoring and/or pro-active intervention in ICU.

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