Association of early CD4⁺ T-lymphocyte depletion with 28 day mortality in sepsis: a retrospective single-center cohort study.
6 affiliations
- 1Department of Infectious Disease, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei, China.
- 2Department of Emergency/General Practice, Wuhan University of Science and Technology Affiliated Geriatric Hospital, Wuhan, Hubei, China.
- 3Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
- 4Pediatric Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
- 5The Second Affiliated Clinical College of Wuhan University of Science and Technology, Wuhan, Hubei, China.
- 6Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address: [email protected].
Abstract
Introduction
Sepsis-induced immune dysregulation, characterized by T-cell loss, is associated with poor outcomes. This study investigated the association between early peripheral T-lymphocyte subset profiles and 28 day mortality in patients with sepsis.Methods
In this single-center retrospective cohort study, 60 critically ill patients with sepsis and 30 healthy controls were included. Patients with sepsis were classified as 28 day survivors (n = 30) or non-survivors (n = 30). Peripheral T-lymphocyte subset percentages (CD3⁺, CD4⁺, and CD8⁺) were measured by flow cytometry within 24 h of ICU admission.Results
Compared with healthy controls, patients with sepsis had lower CD3⁺ (55.23±9.15%vs. 68.12±8.04%) and CD4⁺ T-cell percentages (30.88±10.52%vs. 40.15±7.21%) and a lower CD4⁺/CD8⁺ ratio (all p < 0.001). Non-survivors had lower CD3⁺ and CD4⁺ T-cell percentages than survivors (both p < 0.001). In multivariable logistic regression, lower CD4⁺ T-cell percentage (OR = 0.85, 95% CI 0.77-0.94; p = 0.002) and higher APACHE II score (OR = 1.42, 95% CI 1.18-1.71; p < 0.001) were independently associated with 28-day mortality. Adding CD4⁺ T-cell percentage to APACHE II increased the area under the receiver operating characteristic curve from 0.86 to 0.91 (p = 0.03).Conclusion
Early reduction in peripheral CD4⁺ T-cell percentage was independently associated with 28 day mortality in this selected cohort. CD4⁺ T-cell assessment may provide incremental prognostic information beyond APACHE II, but external validation in larger prospective cohorts is required.
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BibTeX
@article{pan2026association,
title = {{Association of early CD4⁺ T-lymphocyte depletion with 28 day mortality in sepsis: a retrospective single-center cohort study.}},
author = {Deng Pan and Pin Peng and Yu Fang and Jun Lu and Wendi Zhang and Shanshan Hu and Minghao Fang},
journal = {Clinics (Sao Paulo, Brazil)},
year = {2026},
month = oct,
doi = {10.1016/j.clinsp.2026.101173},
url = {https://europepmc.org/article/MED/42880129},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of early CD4⁺ T-lymphocyte depletion with 28 day mortality in sepsis: a retrospective single-center cohort study.
AU - Deng Pan
AU - Pin Peng
AU - Yu Fang
AU - Jun Lu
AU - Wendi Zhang
AU - Shanshan Hu
AU - Minghao Fang
PY - 2026
DA - 2026/10/15
JO - Clinics (Sao Paulo, Brazil)
DO - 10.1016/j.clinsp.2026.101173
UR - https://europepmc.org/article/MED/42880129
AB - Introduction Sepsis-induced immune dysregulation, characterized by T-cell loss, is associated with poor outcomes. This study investigated the association between early peripheral T-lymphocyte subset profiles and 28 day mortality in patients with sepsis.Methods In this single-center retrospective cohort study, 60 critically ill patients with sepsis and 30 healthy controls were included. Patients with sepsis were classified as 28 day survivors (n = 30) or non-survivors (n = 30). Peripheral T-lymphocyte subset percentages (CD3⁺, CD4⁺, and CD8⁺) were measured by flow cytometry within 24 h of ICU admission.Results Compared with healthy controls, patients with sepsis had lower CD3⁺ (55.23±9.15%vs. 68.12±8.04%) and CD4⁺ T-cell percentages (30.88±10.52%vs. 40.15±7.21%) and a lower CD4⁺/CD8⁺ ratio (all p < 0.001). Non-survivors had lower CD3⁺ and CD4⁺ T-cell percentages than survivors (both p < 0.001). In multivariable logistic regression, lower CD4⁺ T-cell percentage (OR = 0.85, 95% CI 0.77-0.94; p = 0.002) and higher APACHE II score (OR = 1.42, 95% CI 1.18-1.71; p < 0.001) were independently associated with 28-day mortality. Adding CD4⁺ T-cell percentage to APACHE II increased the area under the receiver operating characteristic curve from 0.86 to 0.91 (p = 0.03).Conclusion Early reduction in peripheral CD4⁺ T-cell percentage was independently associated with 28 day mortality in this selected cohort. CD4⁺ T-cell assessment may provide incremental prognostic information beyond APACHE II, but external validation in larger prospective cohorts is required.
SN - 1807-5932
SN - 1980-5322
ER -