ArticleClinics (Sao Paulo, Brazil)2026
Association of early CD4⁺ T-lymphocyte depletion with 28 day mortality in sepsis: a retrospective single-center cohort study.
Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSepsis-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.
methodsIn 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.
resultsCompared 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).
conclusionEarly 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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