tbuckley/cabot-search huggingface dataset:
Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis
Authors: Marta Rodríguez-Carrasco, Gianluca Esposito, Diogo Libânio, Pedro Pimentel-Nunes, Mário Dinis-Ribeiro
Journal: Endoscopy (2020)

BACKGROUND : Image-enhanced endoscopy (IEE) improves the accuracy of endoscopic diagnosis. We aimed to assess the value of IEE for gastric preneoplastic conditions and neoplastic lesions. METHODS : Medline and Embase were searched until December 2018. Studies allowing calculation of diagnostic measures were included. Risk of bias and applicability were assessed using QUADAS-2. Subgroup analysis was performed to explore heterogeneity. RESULTS : 44 studies met the inclusion criteria. For gastric intestinal metaplasia (GIM), narrow-band imaging (NBI) obtained a pooled sensitivity and specificity of 0.79 (95 %CI 0.72-0.85) and 0.91 (95 %CI 0.88-0.94) on per-patient basis; on per-biopsy basis, it was 0.84 (95 %CI 0.81-0.86) and 0.95 (95 %CI 0.94-0.96), respectively. Tubulovillous pattern was the most accurate marker to detect GIM and it was effectively assessed without high magnification. For dysplasia, NBI showed a pooled sensitivity and specificity of 0.87 (95 %CI 0.84-0.89) and 0.97 (95 %CI 0.97-0.98) on per-biopsy basis. The use of magnification improved the performance of NBI to characterize early gastric cancer (EGC), especially when the vessel plus surface (VS) classification was applied. Regarding other technologies, trimodal imaging also obtained a high accuracy for dysplasia (sensitivity 0.93 [95 %CI 0.85-0.98], specificity 0.98 [95 %CI 0.92-1.00]). For atrophic gastritis, no specific pattern was noted and none of the technologies reached good diagnostic yield. CONCLUSION : NBI is highly accurate for GIM and dysplasia. The presence of tubulovillous pattern and the VS classification seem to be useful to detect GIM and characterize EGC, respectively. These features should be used in current practice and to standardize endoscopic criteria for other technologies.
OP0043 RENAL TUBULAR COMPLEMENT C9 DEPOSITION IS ASSOCIATED WITH RENAL TUBULAR DAMAGE AND FIBROSIS IN LUPUS NEPHRITIS
Authors: S. Wang, M. Wu, L. Chiriboga, C. Putterman, B. Goilav, A. R. Broder, H. M. Belmont
Journal: Annals of the Rheumatic Diseases (2020)

Background: Tubulointerstitial damage in lupus nephritis (LN) is a strong predictor of progression to chronic kidney disease and end stage renal disease (ESRD). While prior studies showed complement activation mediates glomerular injury (1), the role of complement in renal tubular damage has not been evaluated. Objectives: To investigate the association between complement activation and tubulointerstitial fibrosis. Specifically, to study the role of tubular complement C9 deposition as a marker of tubular damage and fibrosis in LN. Methods: LN biopsies stored in the pathology department between July 2014 to July 2016 were evaluated. Chromogenic immunohistochemistry was performed on formalin-fixed, paraffin-embedded, 4-µm human renal biopsy sections using unconjugated, murine anti-human Complement C9 (Hycult Biotech, clone X197) as a marker of the terminal complement activation. C3 glomerulopathy was used as a positive control, and normal kidney from resected tumor served as a negative control. Tubular basement membrane C9 staining intensity were analyzed on a semi-quantitative scale from 0 to 3 by a renal pathologist. The degree of Interstitial fibrosis/tubular atrophy was categorized as low (0–10%), medium (11–20%), or high (≥21%). Clinical parameters were assessed at the time of biopsy and 6 months post biopsy. Results: Renal biopsies from 30 LN were studied, 23 (77%) of which had proliferative LN (Table). There were 24 (80%) women, mean (SD) age 33 (12) years. Positive tubular C9 staining (C9+) was observed in 7 (23%) biopsies. There was no significant difference in eGFR at renal biopsy between the two groups. At the time of renal biopsy, C9+ patients had significantly higher proteinuria, compared to C9- patients: median (IQR) 6.2g (3.3-13.1) vs. 2.4g (1.3-4.6), p&lt;0.01. The differences persisted at 6 months after induction therapy with cyclophosphamide, cellcept or clinical trial drug: 1.08g (1.0-8.3) in C9+ vs. 0.68g (0.2-2.1) in C9- patients, p=0.06 Tubular C9 deposition was associated with interstitial fibrosis: 3 out of 7 (42.9%) had severe interstitial fibrosis vs. none in the C9- group, p=&lt;0.01. Higher proportion of C9+ patients had moderate NIH Chronicity index: 3 out of 7 (42.9%) vs 2 out of 23 (8.7%) in the C9- group, p=0.07. Table. Comparisons of C9+ and C9- biopsies Conclusion: Tubular C9 deposition is significantly associated with proteinuria, interstitial fibrosis and increased chronicity which predict progression to ESRD and mortality. Complement activation in the tubules may be linked to proteinuria and more studies are needed to elucidate its mechanism in tubulointerstitial damage in LN. References: [1]Wang S, Wu M, Chiriboga L, Zeck B, Belmont HM. Membrane attack complex (mac) deposition in lupus nephritis is associated with hypertension and poor clinical response to treatment. Semin Arthritis Rheum. 2018;48(2):256-62. Disclosure of Interests: None declared
Abstract 13281: Physiological Glucagon Acts as a Guardian of the Heart Against Catecholamine Surge Induced by Pressure-Overload
Authors: Kazuyuki Nishimura, Yasuko K Bando, Takahiro Kamihara, Reina Ozaki, Remina Yasheng, Toyoaki Murohara
Journal: Circulation (2018)

Introduction: Glucagon (Gcg) is one of the glucose-regulatory hormones that modulates various pathophysiological function independently of glucose metabolism. Previous studies suggest that pharmaco...
Concomitant Medications and Comorbidities Affect Early Response in CML Patients Treated with Imatinib: A Retrospective Analysis of 340 Patients from the Polish Adult Leukemia Group (PALG) Registry
Authors: Joanna Gora Tybor, Tomasz Sacha, Joanna Waclaw, Joanna Niesiobedzka-Krezel, Olga Grzybowska-Izydorczyk, Ewa Medras, Izabela Deren-Wagemann, Elzbieta Patkowska, Ilona Seferynska, Krzysztof Lewandowski, Anna Wache, Beata Blajer-Olszewska, Marzena Watek, Ewa Wasilewska, Tomasz Stoklosa, Krzysztof Warzocha, Krzysztof Jamroziak
Journal: Blood (2017)
Abstract IA10: Activating innate and adaptive immunity to improve outcome for “cold” tumors
Authors: Paul M. Sondel
Journal: Cancer Research (2020)

Abstract Unlike some adult cancers, most pediatric cancers are considered immunologically cold and generally less responsive to immunotherapy. Anti-GD2 mAb plus cytokine-based immunotherapy has already been incorporated into standard-of-care treatment for pediatric patients with high-risk neuroblastoma achieving remission. However, overall survival remains poor. We are pursuing clinical and preclinical studies to engage innate and adaptive immune responses against immunologically cold tumors. In a recent trial of adjuvant/neoadjuvant anti-GD2 mAb + IL2 (in the form of the hu14.18-IL2 immunocytokine) for advanced resectable melanoma, we evaluated whole-genome transcriptomics (using RNAseq determined immunologic signatures found to be predictive of outcome for patients with neuroblastoma) on resected tumors. The immunologic signatures were highly correlated with overall survival and relapse-free survival for tumors obtained 2 weeks after starting hu14.18-IL2, but not for tumors obtained 2 weeks before starting hu14.18-IL2. In a “functionally cold” mouse melanoma model, we found that radiation and hu14.18-IL2 immunocytokine generate an in situ vaccination-induced adaptive immune response in syngeneic mice bearing large tumors. In contrast, this same approach was not effective in mice bearing a very cold, low-tumor-mutation burden, MYCN driven syngeneic neuroblastoma (9464D-GD2). The addition of checkpoint blockade (IgG2a anti-CTLA-4) was not able to induce tumor eradication. However, the further addition of CpG (as a “danger signal”) and agonist anti-CD40 mAb (as an activator of effector macrophages and of dendritic cells) resulted in tumor-free mice with immune memory. These results suggest that immune activation, with “off the shelf” reagents, may be applicable to the treatment of cold cancers, via innate/adaptive immune engagement. They also suggest that monitoring of intratumoral immune activation could potentially become a useful predictor of which patients will respond to their therapy and which will require additional or alternate therapy. Citation Format: Paul M. Sondel. Activating innate and adaptive immunity to improve outcome for “cold” tumors [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr IA10.
Delineation of clinical and biological factors associated with cutaneous squamous cell carcinoma among patients with chronic lymphocytic leukemia
Authors: Geffen Kleinstern, Abdul Rishi, Sara J. Achenbach, Kari G. Rabe, Neil E. Kay, Tait D. Shanafelt, Wei Ding, Joe F. Leis, Aaron D. Norman, Timothy G. Call, James R. Cerhan, Sameer A. Parikh, Christian L. Baum, Susan L. Slager
Journal: Journal of the American Academy of Dermatology (2020)
AB0403 VALIDATION OF 2019 EULAR/ACR CLASSIFICATION CRITERIA FOR SYSTEMIC LUPUS ERYTHEMATOSUS IN A SOUTH INDIAN COHORT
Authors: M. Chalakkarayil Bhagavaldas, H. B, S. Balan
Journal: Annals of the Rheumatic Diseases (2020)

Background: New 2019 EULAR/ACR classification criteria for Systemic Lupus Erythematosus (SLE) has been recently published 1 . Before its widespread use in research, this criterion needs to be externally validated in other cohorts. Validation studies for the new criteria were not yet done in the Indian population. Moreover, the new 2019 EULAR/ACR classification criteria for SLE has not been validated in juvenile SLE. Objectives: To compare the real-world performance of 2019 EULAR/ACR classification criteria when applied to a known cohort of SLE cases, comprising both adult and juvenile SLE, in South Indian population. Methods: We retrospectively reviewed the electronic medical record of 30,541 patients who visited the Rheumatology department of Amrita Institute of Medical Sciences, Kochi, a tertiary care centre in Kerala, from January 2014 to June 2019. 347 patients diagnosed with SLE by qualified and experienced rheumatologists were included in the study. 44 patients were later excluded as they were found to have an overlap syndrome. From the 30,541 patients, another 303 age-matched patients, who attended the rheumatology department on the first week of each month, from 2014 January to 2019 June, and diagnosed with autoimmune diseases other than SLE, were selected as controls. They were selected regardless of their specific clinical or immunologic manifestations. Patients were excluded if the diagnosis was uncertain. Each patient was evaluated to see if he or she satisfied the 1997, 2012, and 2019 classification criteria, respectively. Results: Validation of the 2019 SLE classification criteria Criteria Adult (n=196) Juvenile (n=107) Total (n=303) 1997 2012 2019 1997 2012 2019 1997 2012 2019 Sensitivity(%) 78.1 96.4 98.5 73.8 94.4 96.2 76.6 95.7 97.7 Specificity(%) 92.9 86.2 93.4 100 96.3 98.1 95.4 89.8 95 PPV # (%) 91.6 87.5 93.7 100 96.2 98.1 94.3 90.3 95.2 NPV * (%) 80.9 96 98.4 79.3 94.5 96.3 80.3 96.5 97.6 Accuracy(%) 85.5 91.3 95.9 86.9 95.3 97.2 86 92.7 96.4 #PPV- Positive Predictive Value *NPV- Negative Predictive Value Conclusion: In our cohort, the new 2019 EULAR/ACR criteria attained better sensitivity, PPV, NPV and accuracy when compared to ACR 1997 and SLICC 2012 criteria, and had almost the same specificity as compared to SLICC 2012 and ACR 1997 criteria. References: [1]Aringer M, Costenbader K, Daikh D, et al. 2019 European League against Rheumatism/American College of rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis2019;78:1151–9 [2]Petri M, Orbai A-M, Alarcón GS, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheumatism 2012;64:2677–86 [3]Hochberg MC. Updating the American College of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum1997;40 Disclosure of Interests: None declared
Impact of the COVID-19 pandemic on UK endoscopic activity and cancer detection: a National Endoscopy Database Analysis
Authors: Matthew D Rutter, Matthew Brookes, Thomas J Lee, Peter Rogers, Linda Sharp
Journal: Gut (2020)

Objective The COVID-19 pandemic has had a major global impact on endoscopic services. This reduced capacity, along with public reluctance to undergo endoscopy during the pandemic, might result in excess mortality from delayed cancer diagnosis. Using the UK’s National Endoscopy Database (NED), we performed the first national analysis of the impact of the pandemic on endoscopy services and endoscopic cancer diagnosis. Design We developed a NED COVID-19 module incorporating procedure-level data on all endoscopic procedures. Three periods were designated: pre-COVID (6 January 2020 to 15 March), transition (16–22 March) and COVID-impacted (23 March–31 May). National, regional and procedure-specific analyses were performed. The average weekly number of cancers, proportion of missing cancers and cancer detection rates were calculated. Results A weekly average of 35 478 endoscopy procedures were performed in the pre-COVID period. Activity in the COVID-impacted period reduced to 12% of pre-COVID levels; at its low point, activity was only 5%, recovering to 20% of pre-COVID activity by study end. Although more selective vetting significantly increased the per-procedure cancer detection rate (pre-COVID 1.91%; COVID-impacted 6.61%; p&lt;0.001), the weekly number of cancers detected decreased by 58%. The proportion of missing cancers ranged from 19% (pancreatobiliary) to 72% (colorectal). Conclusion This national analysis demonstrates the remarkable impact that the pandemic has had on endoscopic services, which has resulted in a substantial and concerning reduction in cancer detection. Major, urgent efforts are required to restore endoscopy capacity to prevent an impending cancer healthcare crisis.
Abstract 1571: Association of Chronic Kidney Disease With Atrial Fibrillation in the United States
Authors: Usman Baber, Virginia Howard, Jonathan L Halperin, Elsayed Z Soliman, Xiao Zhang, William M McClellan, David G Warnock, Paul Muntner
Journal: Circulation (2009)

Atrial fibrillation (AF) is common among patients with end-stage renal disease, but little is known about its prevalence among adults with chronic kidney disease (CKD) of lesser severity. We studied the association of CKD with electrocardiogram-confirmed AF among 26,917 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a population-based cohort of African-American and white US adults ≥45 years of age. During an in-home study visit, blood and urine samples were collected and electrocardiograms were conducted by trained staff. Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease study equation and microalbuminuria was defined as a urinary albumin to creatinine ratio ≥30 mg/g. Patients were categorized by renal function: no CKD (eGFR ≥60 ml/min/1.73m 2  without microalbuminuria; n=21,081), stage 1–2 CKD (eGFR ≥60 ml/min/1.73m 2  with microalbuminuria; n=2,938), stage 3 CKD (eGFR 30 to 59 ml/min/1.73m 2 ; n=2,683) and stage 4 –5 CKD (eGFR  2 ; n=215). The prevalence of AF in each category was 1.0, 2.8, 2.7 and 4.2%, respectively. Compared to participants without CKD, the age, race, sex adjusted odds ratios for prevalent AF were 2.67 (95% CI 2.04 –3.48), 1.68 (95% CI 1.26 –2.24) and 3.52 (95% CI 1.73–7.15) among those with stage 1–2, stage 3 and stage 4 –5 CKD, respectively (Table). The association between CKD and prevalent AF was attenuated but remained statistically significant after further multivariable adjustment. This association also remained consistent across subgroups, including African-Americans and whites. In conclusion, CKD is associated with an increased prevalence of AF in this population-based cohort of US adults.
Meeting Maternal Mental Health Needs During the COVID-19 Pandemic
Authors: Alison Hermann, Elizabeth M. Fitelson, Veerle Bergink
Journal: JAMA Psychiatry (2020)

JAMA Insights Caring for Women Who Are Planning Pregnancy, Pregnant, or Postpartum During the COVID-19 Pandemic Sonja A. Rasmussen, MD, MS; Denise J. Jamieson, MD, MPH
Muscle structural, energetic and functional benefits of endurance exercise training in sickle cell disease
Authors: Angèle N. Merlet, Léonard Féasson, Pablo Bartolucci, Christophe Hourdé, Céline Schwalm, Barnabas Gellen, Frédéric Galactéros, Louise Deldicque, Marc Francaux, Laurent A. Messonnier
Journal: American Journal of Hematology (2020)

Sickle cell disease (SCD) patients display skeletal muscle hypotrophy, altered oxidative capacity, exercise intolerance and poor quality of life. We previously demonstrated that moderate-intensity endurance training is beneficial for improving muscle function and quality of life of patients. The present study evaluated the effects of this moderate-intensity endurance training program on skeletal muscle structural and metabolic properties. Of the 40 randomized SCD patients, complete data sets were obtained from 33. The training group (n = 15) followed a personalized moderate-intensity endurance training program, while the non-training (n = 18) group maintained a normal lifestyle. Biopsies of the vastus lateralis muscle and submaximal incremental cycling tests were performed before and after the training program. Endurance training increased type I muscle fiber surface area (P = .038), oxidative enzyme activity [citrate synthase, P < .001; β-hydroxyacyl-CoA dehydrogenase, P = .009; type-I fiber cytochrome c oxidase, P = .042; respiratory chain complex IV, P = .017] and contents of respiratory chain complexes I (P = .049), III (P = .005), IV (P = .003) and V (P = .002). Respiratory frequency, respiratory exchange ratio, blood lactate concentration and rating of perceived exertion were all lower at a given submaximal power output after training vs non-training group (all P < .05). The muscle content of proteins involved in glucose transport and pH regulation were unchanged in the training group relative to the non-training group. The moderate-intensity endurance exercise program improved exercise capacity and muscle structural and oxidative properties. This trial was registered at www.clinicaltrials.gov as #NCT02571088.
Changes in Background Liver Function in Patients with Hepatocellular Carcinoma over 30 Years: Comparison of Child-Pugh Classification and Albumin Bilirubin Grade
Authors: Takashi Kumada, Hidenori Toyoda, Toshifumi Tada, Satoshi Yasuda, Junko Tanaka
Journal: Liver Cancer (2020)

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Background liver function in patients with hepatocellular carcinoma (HCC) has improved remarkably with advances in various treatments. Recently, the Child-Pugh classification (CPC) system has been recognized as limited in its ability to assess patients with good hepatic reserve. We compared the albumin-bilirubin (ALBI) grade, which is suitable for a more detailed evaluation of patients with good liver function, with CPC over a 30-year period. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; A total of 2,347 patients were analyzed. Patients were stratified by year of diagnosis into 6 groups: Group A (1990–1994, &lt;i&gt;n&lt;/i&gt; = 376), Group B (1995–1999, &lt;i&gt;n&lt;/i&gt; = 434), Group C (2000–2004, &lt;i&gt;n&lt;/i&gt; = 438), Group D (2005–2009, &lt;i&gt;n&lt;/i&gt; = 444), Group E (2010–2014, &lt;i&gt;n&lt;/i&gt; = 392), and Group F (2015–2018, &lt;i&gt;n&lt;/i&gt; = 263). We compared ALBI grade and CPC across the groups. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The prevalence of patients with CPC A at diagnosis increased throughout the study period, reaching nearly 80% in Groups E and F (&lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.001). By contrast, the percentage of patients with ALBI grade 1 disease remained approximately 50% in Groups E and F (&lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.001). Modified ALBI (mALBI) grade 2a corresponds to patients with CPC A who have poor hepatic function. There were significant survival differences between patients with mALBI grade 1 versus 2a, 1 versus 2b, and 2a versus 2b disease, respectively (&lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.0001), in patients with CPC A. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; CPC is not suitable for assessing patients with recently diagnosed HCC and good remnant hepatic function. In such patients with HCC, the prognosis can be stratified by ALBI grade rather than CPC.
The activation trajectory of plasmacytoid dendritic cells in vivo during a viral infection
Authors: Abdenour Abbas, Thien-Phong Vu Manh, Michael Valente, Nils Collinet, Noudjoud Attaf, Chuang Dong, Karima Naciri, Rabie Chelbi, Geoffray Brelurut, Inaki Cervera-Marzal, Benjamin Rauwel, Jean-Luc Davignon, Gilles Bessou, Morgane Thomas-Chollier, Denis Thieffry, Alexandra-Chloé Villani, Pierre Milpied, Marc Dalod, Elena Tomasello
Journal: Nature Immunology (2020)
Out-of-Hospital Cardiac Arrest and Acute Coronary Syndrome Hospitalizations During the COVID-19 Surge
Authors: Stavros E. Mountantonakis, Moussa Saleh, Kristie Coleman, Jeffrey Kuvin, Varinder Singh, Rajiv Jauhar, Lawrence Ong, Michael Qiu, Laurence M. Epstein
Journal: Journal of the American College of Cardiology (2020)
Factor VIII–driven changes in activated factor IX explored by hydrogen-deuterium exchange mass spectrometry
Authors: Nadia Freato, Eduard H. T. M. Ebberink, Josse van Galen, Caroline Fribourg, Mariëtte Boon-Spijker, Floris P. J. van Alphen, Alexander B. Meijer, Maartje van den Biggelaar, Koen Mertens
Journal: Blood (2020)
Involvement of liver in COVID-19: systematic review and meta-analysis
Authors: Dipesh Kumar Yadav, Akanand Singh, Qi Zhang, Xueli Bai, Wei Zhang, Rajesh Kumar Yadav, Alina Singh, Li Zhiwei, Vishnu Prasad Adhikari, Tingbo Liang
Journal: Gut (2020)

Involvement of liver in COVID-19: systematic review and meta-analysisWe have read with interest the recent study by Qi et al. 1 Currently, the impact of COVID-19 on the liver remains unexplored.Although majority of patients with COVID-19 have abnormal liver function, most studies on COVID-19 only attribute the severity of disease on the ground of respiratory complications.Thus, we aimed to perform a meta-analysis to estimate the prognosis of patients with COVID-19 stratified according to liver injury.Our metaanalysis includes nine studies 2-10 with a total of 2115 patients (online supplementary file).Abnormal liver function in patients with COVID-19 is possibly multifactorial; that is, drug-induced liver injury (DILI), severe acute respiratory syndrome coronavirus 2 replications in the liver 10 and interorgan cross-talk in acute inflammation. 9Published studies on COVID-19 have shown that 37.2%-76.3% of patients have abnormal liver function. 2 9Similarly, the prevalence of liver injury is reported in about 21.5%-45.71% of patients. 2 10Generally, 7.14%-64.15% of patients with COVID-19 had increased aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT) and bilirubin levels, whereas albumin was decreased to 27.9-33.0g/L in nonsurvivor patients. 6Besides, patients with COVID-19 with chronic liver disease (CLD) might develop decompensated liver as a systemic inflammatory response induced by COVID-19. 1 We found that the prevalence of CLD was 4% (95% CI 1.5 to 6.4,I 2 =89%) among patients with COVID-19, with cirrhosis and hepatitis B being the most common.Likewise, the incidence of liver injury was 27% (95% CI 18.2 to 35.8,I 2 =97%; figure 1). 2-10Of note, older patients with COVID-19 had a higher risk of liver injury (standardised mean difference (SMD): 0.81, 95% CI 0.32 to 1.29, I 2 =85%, p=0.001).Again, most patients with COVID-19 had a noticeable reduction in CD4 and CD8 counts. 9In contrast, severe patients with COVID-19 had increased on July 30, 2023 by guest.