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B cell depletion and signs of sepsis-acquired immunodeficiency in bone marrow and spleen of COVID-19 deceased.
Ihlow, Jana; Michaelis, Edward; Greuel, Selina; Heynol, Verena; Lehmann, Annika; Radbruch, Helena; Meinhardt, Jenny; Miller, Florian; Herbst, Hermann; Corman, Victor Max; Westermann, Jörg; Bullinger, Lars; Horst, David; von Brünneck, Ann-Christin; Elezkurtaj, Sefer.
  • Ihlow J; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. Electronic address: jana.ihlow@charite.de.
  • Michaelis E; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • Greuel S; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • Heynol V; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • Lehmann A; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • Radbruch H; Institute of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • Meinhardt J; Institute of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • Miller F; Department of Pathology, Vivantes Netzwerk für Gesundheit GmbH, Berlin, Germany.
  • Herbst H; Department of Pathology, Vivantes Netzwerk für Gesundheit GmbH, Berlin, Germany.
  • Corman VM; Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research, Berlin, Germany.
  • Westermann J; Department of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, Campus Virchow-Clinic, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
  • Bullinger L; Department of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, Campus Virchow-Clinic, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
  • Horst D; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • von Brünneck AC; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • Elezkurtaj S; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Int J Infect Dis ; 103: 628-635, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1002639
Semantic information from SemMedBD (by NLM)
1. Bone Marrow LOCATION_OF Immunologic Deficiency Syndromes
Subject
Bone Marrow
Predicate
LOCATION_OF
Object
Immunologic Deficiency Syndromes
2. Spleen LOCATION_OF Immunologic Deficiency Syndromes
Subject
Spleen
Predicate
LOCATION_OF
Object
Immunologic Deficiency Syndromes
3. Severe infection PROCESS_OF Patients
Subject
Severe infection
Predicate
PROCESS_OF
Object
Patients
4. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
5. Lymphopenia COEXISTS_WITH COVID-19
Subject
Lymphopenia
Predicate
COEXISTS_WITH
Object
COVID-19
6. Hemopoietic tissue LOCATION_OF Lymphopenia
Subject
Hemopoietic tissue
Predicate
LOCATION_OF
Object
Lymphopenia
7. Bone Marrow LOCATION_OF Immunologic Deficiency Syndromes
Subject
Bone Marrow
Predicate
LOCATION_OF
Object
Immunologic Deficiency Syndromes
8. Spleen LOCATION_OF Immunologic Deficiency Syndromes
Subject
Spleen
Predicate
LOCATION_OF
Object
Immunologic Deficiency Syndromes
9. Severe infection PROCESS_OF Patients
Subject
Severe infection
Predicate
PROCESS_OF
Object
Patients
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Lymphopenia COEXISTS_WITH COVID-19
Subject
Lymphopenia
Predicate
COEXISTS_WITH
Object
COVID-19
12. Hemopoietic tissue LOCATION_OF Lymphopenia
Subject
Hemopoietic tissue
Predicate
LOCATION_OF
Object
Lymphopenia
ABSTRACT

OBJECTIVES:

In coronavirus disease 2019 (COVID-19), the adaptive immune response is of considerable importance, and detailed cellular immune reactions in the hematological system of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are yet to be clarified.

METHODS:

This study reports the morphological characterization of both bone marrow and spleen in 11 COVID-19 decedents with respect to findings in the peripheral blood and pulmonary SARS-CoV-2 burden.

RESULTS:

In the bone marrow, activation and left shift were found in at least 55% of patients, which was mirrored by peripheral anaemia, granulocytic immaturity and multiple thromboembolic events. Signs of sepsis-acquired immunodeficiency were found in the setting of an abscess-forming superinfection of viral COVID-19 pneumonia. Furthermore, a severe B cell loss was observed in the bone marrow and/or spleen in 64% of COVID-19 patients. This was reflected by lymphocytopenia in the peripheral blood. As compared to B cell preservation, B cell loss was associated with a higher pulmonary SARS-CoV-2 burden and only a marginal decrease of of T cell counts.

CONCLUSIONS:

The results of this study suggest the presence of sepsis-related immunodeficiency in severe COVID-19 pneumonia with superinfection. Furthermore, our findings indicate that lymphocytopenia in COVID-19 is accompanied by B cell depletion in hematopoietic tissue, which might impede the durability of the humoral immune response to SARS-CoV-2.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Spleen / Bone Marrow / B-Lymphocytes / Sepsis / SARS-CoV-2 / COVID-19 / Lymphopenia Subject: Spleen / Bone Marrow / B-Lymphocytes / Sepsis / SARS-CoV-2 / COVID-19 / Lymphopenia Type of study: Diagnostic study Language: English Journal: Int J Infect Dis Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Spleen / Bone Marrow / B-Lymphocytes / Sepsis / SARS-CoV-2 / COVID-19 / Lymphopenia Subject: Spleen / Bone Marrow / B-Lymphocytes / Sepsis / SARS-CoV-2 / COVID-19 / Lymphopenia Type of study: Diagnostic study Language: English Journal: Int J Infect Dis Clinical aspect: Etiology Year: 2021
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