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Our study aimed to explore the predictive roles of chronic infections, lymphopenia, and lymphocyte subsets on unexpected admission and mortality in the institutionalized oldest-old during 3\u2009year follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 163 participants enrolled prospectively with median age of 87.3\u2009years (IQR: 83.1\u201390.2), male of 88.3%, and being followed for 156.4\u2009weeks (IQR: 136.9\u2013156.4\u2009weeks). The unexpected admission and mortality rates were 55.2 and 24.5% respectively. The Cox proportional hazards models demonstrated the 3rd quartile of cytomegalovirus IgG (OR: 3.26, 95% CI: 1.55\u20136.84), lymphopenia (OR: 2.85, 95% CI: 1.2\u20136.74), and 1st quartile of CD19<jats:sup>+<\/jats:sup>B cell count (OR: 2.84, 95% CI: 1.29\u20136.25) predicted elevated risks of unexpected admission after adjusting for potential confounders; while the 3rd quartile of CD3<jats:sup>+<\/jats:sup>T cell indicated a reduced risk of mortality (OR: 0.19, 95% CI: 0.05\u20130.71). Negative association between CMV IgG and CD19<jats:sup>+<\/jats:sup>B cell count suggested that CMV infection might lead to B cell depletion via decreasing memory B cells repertoire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CMV infection, lymphopenia, and CD19<jats:sup>+<\/jats:sup>B cell depletion might predict greater risk of unexpected admission, while more CD3<jats:sup>+<\/jats:sup>T cell would suggest a reduced risk of mortality among the oldest-old population. A non-linear or U-shaped relationship was supposed between health outcomes and CMV infection, CD3<jats:sup>+<\/jats:sup>T cell, or CD19<jats:sup>+<\/jats:sup>B cell counts. Further prospective studies with more participants included would be needed to elucidate above findings.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12979-021-00233-0","type":"journal-article","created":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T08:04:55Z","timestamp":1620115495000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["CMV infection, CD19+ B cell depletion, and Lymphopenia as predictors for unexpected admission in the institutionalized elderly"],"prefix":"10.1186","volume":"18","author":[{"given":"Liang-Yu","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An-Chun","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Yu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang-Kung","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu-Der","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Jiun","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"issue":"1","key":"233_CR1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.cell.2009.06.036","volume":"138","author":"HW Virgin","year":"2009","unstructured":"Virgin HW, Wherry EJ, Ahmed R. 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