AUTHOR=Lin Hua-Song , Lin Xiao-Hong , Wang Jian-Wen , Wen Dan-Ning , Xiang Jie , Fan Yan-Qing , Li Hua-Dong , Wu Jing , Lin Yi , Lin Ya-Lan , Sun Xu-Ri , Chen Yun-Feng , Chen Chuan-Juan , Lian Ning-Fang , Xie Han-Sheng , Lin Shou-Hong , Xie Qun-Fang , Li Chao-Wei , Peng Fang-Zhan , Wang Ning , Lin Jian-Qing , Chen Wan-Jin , Huang Chao-Lin , Fu Ying 

TITLE=Exhausting T Cells During HIV Infection May Improve the Prognosis of Patients with COVID-19

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2021.564938

DOI=10.3389/fcimb.2021.564938

ISSN=2235-2988

ABSTRACT=T-cell reduction is an important characteristic of the coronavirus disease 2019 (COVID-19), and its immunopathology are a subject of debate. It may be due to a direct effect of the virus on T cell exhaustion, or indirectly due to T-cell redistributing to lung. HIV/AIDS naturally served as a T cell exhaustion disease model for us to recognize how immune system work in duration of COVID-19. We respectively collected clinical charts, T lymphocyte analysis, and chest CT for HIV patients with laboratory confirmed COVID-19 infection who were admitted to Jin Yin-Tan Hospital (Wuhan, China). Median age of the 21 patients was 47 (IQR 40–50) and median CD4 cell count was 183 cells/μl (IQR 96-289). 11 HIV patients were in non-AIDS stage and 10 were in AIDS stage. Nine patients received antiretroviral treatment (ART) and 12 patients did not receive any treatment. Compared to the reported mortality rate (nearly 4-10%) and severe rate (up to 20-40%) among hospital patients with COVID-19, 21 HIV/AIDS patients showed benign duration with 0% severe and mortality rate. The severity of COVID-19 was similar in non-AIDS patients (median CD4, 287 cells/μl) and AIDS patients (median CD4, 97 cells/μl), even if some AIDS patients have baseline lung injury aroused from HIV: 7 patients (33%) was mild (5 in non-AIDS group and 2 in AIDS group), 14 patients were (67%) moderate (6 in non-AIDS group and 8 in AIDS group). More important, we found that reduction in T-cell numbers positively correlates with serum levels of IL-6 and CRP, which was contrary to the reported findings of immune response in patients with COVID-19 (lower CD4 T cells with higher level of IL-6 and CRP). In HIV/AIDS, a compromised immune system with a lower CD4 counts level might waive clinical symptoms and inflammatory responses, which suggested lymphocyte redistribution as immunopathology lead to lymphopenia in COVID-19.