Journal Article

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

Fortier, Sérgio C., Furquim, Thyago, Bozza, Fernando A., De Luca, Fábio, Silva, Flávia A., Medei, Emiliano, Cabral-Castro, Mauro, Luiz, Ronir R., Loures, Vitor A., Giusti, Karla, Barros e Silva, Pedro, Vera, Narendra, Santos, Mayara F., Arruda, Guilherme, Paula, Thiago C., Sousa, Andréa S., Conde, Luciana, Domiciano, Rafael, Albuquerque, Denílson C., Kotsugai, Marisol, Souza, Olga F., Feldman, André, Moll-Bernardes, Renata, Macedo, Ariane, Lopes, Renato D., Oliveira, Nathália

2022

Overview

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.

• Publisher: MDPI AG,MDPI
• Subject: Antiviral drugs / Biomarkers / Cardiovascular disease / Clinical medicine / Coronaviruses / COVID-19 / Diabetes / Disease progression / Flow cytometry / Hypertension / Immune response / Infections / Laboratories / Lymphocytes / Severe acute respiratory syndrome coronavirus 2 / Ventilators