{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:19:04Z","timestamp":1790403544206,"version":"4.1.0"},"reference-count":25,"publisher":"American Society for Clinical Investigation","issue":"13","funder":[{"DOI":"10.13039\/501100003397","name":"Huazhong University of Science and Technology","doi-asserted-by":"crossref","award":["81772477"],"award-info":[{"award-number":["81772477"]}],"id":[{"id":"10.13039\/501100003397","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Fatal cases of COVID-19 are increasing globally. We retrospectively investigated the potential of immunologic parameters as early predictors of COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A total of 1018 patients with confirmed COVID-19 were enrolled in our 2-center retrospective study. Clinical feature, laboratory test, immunological test, radiological findings, and outcomes data were collected. Univariate and multivariable logistic regression analyses were performed to evaluate factors associated with in-hospital mortality. Receiver operator characteristic (ROC) curves and survival curves were plotted to evaluate their clinical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The counts of all T lymphocyte subsets were markedly lower in nonsurvivors than in survivors, especially CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cells. Among all tested cytokines, IL-6 was elevated most significantly, with an upward trend of more than 10-fold. Using multivariate logistic regression analysis, IL-6 levels of more than 20 pg\/mL and CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts of less than 165 cells\/\u03bcL were found to be associated with in-hospital mortality after adjusting for confounding factors. Groups with IL-6 levels of more than 20 pg\/mL and CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts of less than 165 cells\/\u03bcL had a higher percentage of older and male patients as well as a higher proportion of patients with comorbidities, ventilation, intensive care unit admission, shock, and death. Furthermore, the receiver operating curve of the model combining IL-6 (&gt;20 pg\/mL) and CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts (&lt;165 cells\/\u03bcL) displayed a more favorable discrimination than that of the CURB-65 score. The Hosmer-Lemeshow test showed a good fit of the model, with no statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      IL-6 (&gt;20 pg\/mL) and CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts (&lt;165 cells\/\u03bcL) are 2 reliable prognostic indicators that accurately stratify patients into risk categories and predict COVID-19 mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Funding<\/jats:title>\n                    <jats:p>This work was supported by funding from the National Natural Science Foundation of China (no. 81772477 and 81201848).<\/jats:p>\n                  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