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Extensive longitudinal immune profiling reveals sustained innate immune activation in COVID-19 patients with unfavorable outcome
Schrijver, Benjamin; Assmann, Jorn L J C; van Gammeren, Adriaan J; Vermeulen, Roel C H; Portengen, Lützen; Heukels, Peter; Langerak, Anton W; Dik, Willem A; van der Velden, Vincent H J; Ermens, Ton A A M.
  • Schrijver B; Department of Immunology, Laboratory Medical Immunology, Erasmus MC-University Medical Center Rotterdam, the Netherlands.
  • Assmann JLJC; Department of Immunology, Laboratory Medical Immunology, Erasmus MC-University Medical Center Rotterdam, the Netherlands.
  • van Gammeren AJ; Department of Clinical Chemistry and Hematology, Amphia Hospital, Breda, the Netherlands.
  • Vermeulen RCH; Department of Population Health Sciences, Institute for Risk Assessment Sciences, University Utrecht, Utrecht, the Netherlands.
  • Portengen L; Department of Population Health Sciences, Institute for Risk Assessment Sciences, University Utrecht, Utrecht, the Netherlands.
  • Heukels P; Department of Pulmonology, Amphia Hospital, Breda, the Netherlands.
  • Langerak AW; Department of Immunology, Laboratory Medical Immunology, Erasmus MC-University Medical Center Rotterdam, the Netherlands.
  • Dik WA; Department of Immunology, Laboratory Medical Immunology, Erasmus MC-University Medical Center Rotterdam, the Netherlands.
  • van der Velden VHJ; Department of Immunology, Laboratory Medical Immunology, Erasmus MC-University Medical Center Rotterdam, the Netherlands.
  • Ermens TAAM; Department of Clinical Chemistry and Hematology, Amphia Hospital, Breda, the Netherlands.
Eur Cytokine Netw ; 31(4): 154-167, 2020 12 01.
Article in English | MEDLINE | ID: covidwho-1115342
ABSTRACT
COVID-19 differs substantially between individuals, ranging from mild to severe or even fatal. Heterogeneity in the immune response against SARS-COV-2 likely contributes to this. Therefore, we explored the temporal dynamics of key cellular and soluble mediators of innate and adaptive immune activation in relation to COVID-19 severity and progression. Forty-four patients with a PCR-proven diagnosis of COVID-19 were included. Extensive cellular (leukocytes and T-lymphocyte subsets) and serological immune profiling (cytokines, soluble cell surface molecules, and SARS-CoV-2 antibodies) was performed at hospital admission and every 3-4 days during hospitalization. Measurements and disease outcome were compared between patients with an unfavorable (IC admission and/or death) and favorable (all others) outcome. Patients with an unfavorable outcome had higher leukocyte numbers at baseline, mostly due to increased neutrophils, whereas lymphocyte and monocyte numbers were reduced. CRP, IL-6, CCL2, CXCL10, and GM-CSF levels were higher at baseline in the unfavorable group, whereas IL-7 levels were lower. SARS-CoV-2 antibodies were more frequently absent in the unfavorable group. Longitudinal analysis revealed delayed kinetics of activated CD4 and CD8 T-lymphocyte subsets in the unfavorable group. Furthermore, whereas CRP, IL-6, CXCL10, and GM-CSF declined in the favorable group, these cytokines declined with delayed kinetics, remained increased, or even increased further in the unfavorable group. Our data indicate a state of increased innate immune activation in COVID19-patients with an unfavorable outcome at hospital admission, which remained over time, as compared with patients with a favorable outcome.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: T-Lymphocyte Subsets / SARS-CoV-2 / COVID-19 / Immunity, Innate Type of study: Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Eur Cytokine Netw Journal subject: Allergy and Immunology Year: 2020 Document Type: Article Affiliation country: Ecn.2020.0456

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Full text: Available Collection: International databases Database: MEDLINE Main subject: T-Lymphocyte Subsets / SARS-CoV-2 / COVID-19 / Immunity, Innate Type of study: Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Eur Cytokine Netw Journal subject: Allergy and Immunology Year: 2020 Document Type: Article Affiliation country: Ecn.2020.0456