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Complement Activation in the Disease Course of Coronavirus Disease 2019 and Its Effects on Clinical Outcomes.
de Nooijer, Aline H; Grondman, Inge; Janssen, Nico A F; Netea, Mihai G; Willems, Loek; van de Veerdonk, Frank L; Giamarellos-Bourboulis, Evangelos J; Toonen, Erik J M; Joosten, Leo A B.
  • de Nooijer AH; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Grondman I; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Janssen NAF; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Netea MG; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Willems L; Immunology and Metabolism, Life & Medical Sciences Institute, University of Bonn, Bonn, Germany.
  • van de Veerdonk FL; R&D Department, Hycult Biotechnology, Uden, the Netherlands.
  • Giamarellos-Bourboulis EJ; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Toonen EJM; Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Joosten LAB; R&D Department, Hycult Biotechnology, Uden, the Netherlands.
J Infect Dis ; 223(2): 214-224, 2021 02 03.
Article in English | MEDLINE | ID: covidwho-1081282
ABSTRACT

BACKGROUND:

Excessive activation of immune responses in coronavirus disease 2019 (COVID-19) is considered to be related to disease severity, complications, and mortality rate. The complement system is an important component of innate immunity and can stimulate inflammation, but its role in COVID-19 is unknown.

METHODS:

A prospective, longitudinal, single center study was performed in hospitalized patients with COVID-19. Plasma concentrations of complement factors C3a, C3c, and terminal complement complex (TCC) were assessed at baseline and during hospital admission. In parallel, routine laboratory and clinical parameters were collected from medical files and analyzed.

RESULTS:

Complement factors C3a, C3c, and TCC were significantly increased in plasma of patients with COVID-19 compared with healthy controls (P < .05). These complement factors were especially elevated in intensive care unit patients during the entire disease course (P < .005 for C3a and TCC). More intense complement activation was observed in patients who died and in those with thromboembolic events.

CONCLUSIONS:

Patients with COVID-19 demonstrate activation of the complement system, which is related to disease severity. This pathway may be involved in the dysregulated proinflammatory response associated with increased mortality rate and thromboembolic complications. Components of the complement system might have potential as prognostic markers for disease severity and as therapeutic targets in COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Complement Activation / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Infect Dis Year: 2021 Document Type: Article Affiliation country: Infdis

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Complement Activation / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Infect Dis Year: 2021 Document Type: Article Affiliation country: Infdis