ABSTRACT
PURPOSE: The clinical outcome of COVID-19 disease is worse in males, and the reasons of this gender disparity are currently unclear, though evidences point to a combination of biological and gender-specific factors. A phenomenon unique to the female gender is the fetal cell microchimerism (FCM), defined as the presence of fetal microchimeric cells in maternal organs and in the circulation for years after delivery and usually evaluated by assessing the presence of male cells or DNA in a woman. In the present case-control study, we aimed to evaluate the possible effect of pregnancy and related FCM on the susceptibility to SARS-CoV-2 infection and on the clinical course and outcome of COVID-19. METHODS: One hundred twenty-three women with a previous male pregnancy, comprising 63 COVID-19 cases and 60 healthy controls were enrolled. The presence of blood male DNA was assessed by the amplification of the Y-chromosome specific gene SRY. RESULTS: The prevalence of male DNA of presumed fetal origin was significantly higher in healthy controls than in COVID-19 cases (70 vs 44.4%, P = 0.0044; OR 0.3429, 95% CI 0.1631-0.7207, P = 0.0047). Among women affected with COVID-19, the presence of male FCM did not significantly influence the severity of the disease, though the 8 deceased women studied were all FCM negative. CONCLUSION: This is the first case-control study reporting the prevalence of FCM in COVID-19 and healthy women. Overall, our data seem to suggest a role for FCM in the protection towards the SARS-CoV-2 infection with a possible positive impact on clinical outcome.
ABSTRACT
OBJECTIVES: Lung ultrasound (LUS) might be comparable to chest computed tomography (CT) in detecting parenchymal and pleural pathology, and in monitoring interstitial lung disease. We aimed to describe LUS characteristics of patients during the hospitalization for COVID-19 pneumonia, and to compare the extent of lung involvement at LUS and chest-CT with inflammatory response and the severity of respiration impairment. METHODS: During a 2-week period, we performed LUS and chest CT in hospitalized patients affected by COVID-19 pneumonia. Dosages of high sensitivity C-reactive protein (HS-CRP), d-dimer, and interleukin-6 (IL-6) were also obtained. The index of lung function (P/F ratio) was calculated from the blood gas test. LUS and CT scoring were assessed using previously validated scores. RESULTS: Twenty-six consecutive patients (3 women) underwent LUS 34 ± 14 days from the early symptoms. Among them, 21 underwent CT on the same day of LUS. A fair association was found between LUS and CT scores (R = 0.45, P = .049), which became stronger if the B-lines score on LUS was not considered (R = 0.57, P = .024). LUS B-lines score correlated with IL-6 levels (R = 0.75, P = .011), and the number of involved lung segments detected by LUS correlated with the P/F ratio (R = 0.60, P = .019) but not with HS-CRP and d-Dimer levels. No correlations were found between CT scores and inflammations markers or P/F. CONCLUSION: In patients with COVID-19 pneumonia, LUS was correlated with both the extent of the inflammatory response and the P/F ratio.