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目的:探讨CD4n ＋T淋巴细胞和CD8n ＋T淋巴细胞对新型冠状病毒肺炎(COVID-19)的临床分型及其预后的价值。n 方法:纳入2020年1月至3月上海市(复旦大学附属)公共卫生临床中心收治的95例COVID-19患者，比较普通型、重型、危重型患者及临床转归为治愈、好转、未愈、死亡患者的CD4n ＋T淋巴细胞计数和CD8n ＋T淋巴细胞计数。采用受试者操作特征曲线下面积评估CD4n ＋T淋巴细胞计数和CD8n ＋T淋巴细胞计数对COVID-19临床分型及预后的价值。组间比较采用曼-惠特尼n U检验。n 结果:95例COVID-19患者中，普通型68例，重型11例，危重型16例。治疗前普通型、重型和危重型患者的CD4n ＋T淋巴细胞计数分别为419(309，612)、267(212，540)和141(77，201)/μL，CD8n ＋T淋巴细胞计数分别为238(153，375)、128(96，172)和92(51，144)/μL，差异均有统计学意义(n Z＝24.322、15.956，均n P<0.01)。死亡、未愈、好转和治愈病例的CD4n ＋T淋巴细胞计数分别为149(143，349)、315(116，414)、344(294，426)和745(611，966)/μL，CD8n ＋T淋巴细胞计数分别为106(43，501)、176(67，279)、194(188，432)和429(276，564)/μL，差异均有统计学意义(n Z＝36.083、16.658，均n P<0.01)。评估危重型患者的CD4n ＋T淋巴细胞计数最佳临界值为237/μL，曲线下面积为0.911[95%可信区间(confidence interval, n CI) 0.833～0.989，n P<0.01]，灵敏度和特异度分别为86.1%和87.5%；评估(危)重型患者治疗有效性的CD4n ＋T淋巴细胞计数最佳临界值为405/μL，曲线下面积为0.863(95%n CI 0.727～0.999，n P＝0.001)，灵敏度和特异度分别为78.6%和74.6%。n 结论:COVID-19的病情可能随CD4n ＋T淋巴细胞计数和CD8n ＋T淋巴细胞计数减少呈加重趋势，CD4n ＋T淋巴细胞计数可用作COVID-19临床分型诊断和评估(危)重型病例预后的指标。n “,”Objective:To assess the value of CD4n + and CD8n + T-lymphocyte counts for the diagnostic classification and prognosis of coronavirus disease 2019 (COVID-19).n Methods:A total of 95 COVID-19 adult patients admitted to Shanghai Public Health Clinical Center, Fudan University from January to March 2020 were recruited. The CD4n + and CD8n + T-lymphocyte counts among ordinary, severe and critical patients, as well among the cured, improved, unimproved and death patients were compared. The area under receiver operating characteristic curve (AUROC) was used to evaluate the value of CD4n + and CD8n + T-lymphocyte counts for the clinical diagnosis and prognosis of COVID-19. The comparison among groups was performed by Mann-Whitney n U test.n Results:A total of 95 COVID-19 cases including 68 common, 11 severe and 16 critical cases were enrolled. The counts of CD4n + and CD8n + T-lymphocyte of patients in common, severe and critical groups were 419 (309, 612), 267 (212, 540), 141 (77, 201)/μL, and 238 (153, 375), 128 (96, 172), 92 (51, 144)/μL, respectively, with significant differences (n Z=24.322 and 15.956, respectively, both n P<0.01). The counts of CD4n + and CD8n + T-lymphocyte of the death, unimproved, improved, and cured patients were 149 (143, 349), 315 (116, 414), 344 (294, 426), 745 (611, 966)/μL, and 106 (43, 501), 176(67, 279), 194(188, 432), 429(276, 564)/μL, respectively, with significant differences (n Z=36.083 and 16.658, respectively, both n P<0.01). The optimal cut-off point of CD4n + T-lymphocyte counts was 237/μL for critical COVID-19 with AUROC 0.911 (95% confidence interval (n CI) 0.833-0.989, n P<0.01), with the sensitivity of 86.1% and specificity of 87.5%. For predicting severe and critical cases, the optimal cut-off point of CD4n + T-lymphocyte counts was 405/μL with AUROC 0.863 (95%n CI 0.727-0.999, n P=0.001), with the sensitivity of 78.6% and specificity of 74.6%.n Conclusions:The conditions of patients with COVID-19 are aggravated with CD4n + and CD8n + T-lymphocyte counts decreasing. CD4n + T-lymphocyte counts may be an indicator for diagnostic classification of COVID-19 and prognostic indicator for severe and critical patients.n