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NKG2A Expression among CD8 Cells Is Associated with COVID-19 Progression in Hypertensive Patients: Insights from the BRACE CORONA Randomized Trial

2022; Multidisciplinary Digital Publishing Institute; Volume: 11; Issue: 13 Linguagem: Inglês

10.3390/jcm11133713

2077-0383

Renata Moll-Bernardes, Sérgio Costa Fortier, Andréa Silvestre de Sousa, Renato D. Lópes, Narendra Vera, Luciana Conde, André Feldman, Guilherme Arruda, Mauro Jorge Cabral–Castro, Denílson Campos de Albuquerque, Thiago Ceccatto de Paula, Thyago Antônio Biagioni Furquim, Vitor Alves Loures, Karla G. D. Giusti, NATHALIA RODRIGUES DE OLIVEIRA, Ariane Vieira Scarlatelli Macedo, Pedro Gabriel Melo de Barros e Silva, Fábio De Luca, Marisol D. M. Kotsugai, Rafael Domiciano, Flavia A. Matos e Silva, Mayara Fraga Santos, Olga Ferreira de Souza, Fernando A. Bozza, Ronir Raggio Luiz, Emiliano Medei,

Long-Term Effects of COVID-19

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.