Mengying Yang,* Qianqian Li,* Mengxin Huang, Xiaoman Liu, Baogui Wang

Department of Infectious Disease, Fuyang People’s Hospital, Fuyang, Anhui, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Baogui Wang, Department of Infectious Disease, Fuyang People’s Hospital, No. 501 Sanqing Road, Yingzhou District, Fuyang City, Anhui Province, 236000, People’s Republic of China, Tel +86-13805582057, Email wangbaogui99@163.com

Background: Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) primarily targets mitochondria. However, the description of mitochondrial signaling in immune cells remains limited in COVID-19. This study aimed to elucidate the pivotal roles played by immune cells and mitochondria in the pathogenesis of COVID-19 and the resulting clinical outcomes.
Methods: We obtained epidemiological characteristics, laboratory parameters and T cell mitochondrial damage indicators in 296 COVID-19 patients. And we further evaluated the predictive value of novel T lymphocyte mitochondrial markers and conventional immune inflammatory markers as clinical outcomes in COVID-19 patients. Finally, Binary logistic regression analysis was conducted to identify the independent risk factors associated with the prognosis of patients with COVID-19.
Results: The severe group exhibited lower counts of Mito+CD3+, Mito+CD4+, and Mito+CD8+ cells compared to the non-severe group. Significantly higher positive rates of CD3+, CD3+CD4+, and CD3+CD8+T cell mitochondrial damage were observed in the severe group compared to the non-severe group. The CD3+CD8+T cells MMP-low% had the highest AUC value of 0.864 (95% CI =0.794– 0.934) to evaluate COVID-19 outcome. Binary logistic regression analysis showed that CD3+T cells MMP-low%, CD3+CD4+T cells MMP-low% and CD3+CD8+T cells MMP-low% were independent risk factors for adverse outcomes in COVID-19 patients.
Conclusion: Our research suggests that a substantial proportion of COVID-19 patients exhibited mitochondrial impairment with T-lymphocyte. T cells mitochondrial markers can serve as predictive factors and independent risk factors for predicting adverse outcomes in COVID-19 patients.

Keywords: COVID-19, SARS-Co V-2, mitochondrial damage, T cell subpopulations, prognosis