In order to better understand the CD4 numbers cited by NP yesterday, and as a reference, here is a paper published by the Chinese with measurements from a study in Wuhan with 522 patients with confirmed COVID-19 and 40 healthy people (aged from 2 to 62 years) who came to the hospitals for routine physical examination, as comparison group. Within the cohort analyzed 43 were admitted to ICU:
https://www.medrxiv.org/content/10.1101/2020....20024364v1
Discussion:
So, the numbers cited by NP are extraordinary. Honesty, I am still not sure if the numbers he cited where 4 or 5 or whether he made a mistake (or units are different). In any case, it seems that the Cytokine storm is quelled, the CD4 count goes up, and the immune response is improved & stabilized (which is what Dr. Patterson is reporting) with the result that our patient survives ...
https://www.medrxiv.org/content/10.1101/2020....20024364v1
Quote:Among milder patients in the Non-ICU group, the median value of total T cells, CD4+ and CD8+ T cell counts are 652, 342 and 208, respectively, the median value decreased to 261, 198 and 64.3, respectively, in the ICU group.
These patients were further categorized into three groups based on age (<20 years old, 20～60 years and ≥60 years), and an age-dependent reduction of T cell numbers was observed in COVID-19 patients, with the lowest T cells numbers found in patients ≥60 years old, suggesting a potential cause for increased susceptibility in elderly patients .
Quote:We next retrospectively reviewed T cell numbers in 212 cases from Non-ICU patients within one center (the General Hospital of Central Theatre Command). The Non-ICU patients were further divided into four groups based on clinical outcomes. Among these patients, 151 cases are mild/moderate, 40 cases are severe, while 13 cases in critical condition, and 8 perished occurred. Statistical analysis showed that T cell numbers including total T cells, CD4+ and CD8+ T cells in severe, critical and perished groups are significantly lower than in the mild/moderate group. Most importantly, the numbers of total T cell, CD8+T cells and CD4+ T cells in severe and perished groups are lower than 800/μL, 300/μL, or 400/μL , respectively
Discussion:
Quote:However, in the ICU group, a total of 95% (19/20) patients showed a decrease in both total T cells and CD4+ T cells, and most importantly, all of the patients displayed decreases in CD8+ T cells. We also analyzed Non-ICU patients in greater detail, and found that aggressive intervention may be necessary to preempt the development of severe symptoms in patients with low T cell counts.
Quote:Interestingly, the numbers of total T cells, CD4+ T and CD8+ T cells are negatively correlated to levels of TNF-α, IL-6 and IL-10, respectively suggesting these cytokines promote T cells decrease in COVID-19 patients.
So, the numbers cited by NP are extraordinary. Honesty, I am still not sure if the numbers he cited where 4 or 5 or whether he made a mistake (or units are different). In any case, it seems that the Cytokine storm is quelled, the CD4 count goes up, and the immune response is improved & stabilized (which is what Dr. Patterson is reporting) with the result that our patient survives ...
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