{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T18:43:51Z","timestamp":1770230631113,"version":"3.49.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Understanding immune responses in viral infections such as COVID-19 is crucial for identifying patients at risk of clinical deterioration. Profiling innate and adaptive immune components may provide a basis for precision monitoring and personalised management strategies in infectious and inflammatory syndromes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective observational study, 150 patients were enrolled from 30 March to 15 April 2022, hospitalised for COVID-19 at a tertiary Internal Medicine COVID Unit. Flow cytometry analysis of peripheral blood quantified 34 immune subpopulations. Patients were stratified into immunophenotypic groups based on deficiencies in T helper (CD4), cytotoxic T (CD8), natural killer (NK), and plasma cells. Clinical outcomes were analysed in relation to these immune profiles using multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 150 patients (mean age 64.7 years, 59.1% male), 7.8% required ICU admission and 9.1% died. Lymphopenia (&amp;lt;1200 cells\/\u00b5L) was observed in 84%, with 61.1% showing CD4+ T cell deficiency, 32.2% NK cell deficiency, 46% CD8+ T cell reduction, and 26.6% decreased plasma cells. Notably, 10% had concurrent CD4 and NK cell deficiencies. While low plasma cell counts were not associated with worse outcomes, NK cell deficiency was linked to a threefold increased risk of death or ICU transfer (OR 3.19, p&amp;lt;0.03), and CD4+ T cell reduction was associated with a 5.23-fold increase (p&amp;lt;0.037). The combination of low CD4 and NK cells resulted in a 9.5-fold higher risk of adverse outcome, independently of age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Specific immune profiles, particularly reductions in CD4+ and NK cells, are strong predictors of mortality or ICU admission in hospitalized COVID-19 patients. These findings suggest that rapid and clinically feasible tool may support precision monitoring and personalised management in viral and inflammatory syndromes beyond COVID-19. This study advocates for the integration of immune profiling into the framework of precision medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1683748","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T06:39:46Z","timestamp":1770187186000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Innate and adaptive immune patterns in hospitalised COVID-19 patients: a framework for precision monitoring in viral and inflammatory syndromes"],"prefix":"10.3389","volume":"16","author":[{"given":"Salvatore","family":"Corrao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Relevance and High Specialization Hospital Trust Azienda di Rilievo Nazionale ad Alta Specializzazione (A.R.N.A.S.) Civico, Di Cristina, Benfratelli","place":["Palermo, Italy"]},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties. [PROMISE], University of Palermo","place":["Palermo, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaella Mallaci","family":"Bocchio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Relevance and High Specialization Hospital Trust Azienda di Rilievo Nazionale ad Alta Specializzazione (A.R.N.A.S.) Civico, Di Cristina, Benfratelli","place":["Palermo, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Scibetta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Relevance and High Specialization Hospital Trust Azienda di Rilievo Nazionale ad Alta Specializzazione (A.R.N.A.S.) 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