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Atypical response to bacterial coinfection and persistent neutrophilic bronchoalveolar inflammation distinguish critical COVID-19 from influenza.
Cambier, Seppe; Metzemaekers, Mieke; de Carvalho, Ana Carolina; Nooyens, Amber; Jacobs, Cato; Vanderbeke, Lore; Malengier-Devlies, Bert; Gouwy, Mieke; Heylen, Elisabeth; Meersseman, Philippe; Hermans, Greet; Wauters, Els; Wilmer, Alexander; Schols, Dominique; Matthys, Patrick; Opdenakker, Ghislain; Marques, Rafael Elias; Wauters, Joost; Vandooren, Jennifer; Proost, Paul.
  • Cambier S; Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium.
  • Metzemaekers M; Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium.
  • de Carvalho AC; Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium.
  • Nooyens A; Brazilian Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas, Brazil.
  • Jacobs C; Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil.
  • Vanderbeke L; Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium.
  • Malengier-Devlies B; Laboratory for Clinical Infectious and Inflammatory Disorders and.
  • Gouwy M; Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
  • Heylen E; Laboratory of Immunobiology and.
  • Meersseman P; Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium.
  • Hermans G; Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium.
  • Wauters E; Laboratory for Clinical Infectious and Inflammatory Disorders and.
  • Wilmer A; Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, and.
  • Schols D; Department of Pneumology, University Hospitals Leuven, Leuven, Belgium.
  • Matthys P; Laboratory for Clinical Infectious and Inflammatory Disorders and.
  • Marques RE; Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium.
  • Wauters J; Laboratory of Immunobiology and.
  • Vandooren J; Laboratory of Immunobiology and.
  • Proost P; Brazilian Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas, Brazil.
JCI Insight ; 7(1)2022 01 11.
Article in English | MEDLINE | ID: covidwho-1523122
ABSTRACT
Neutrophils are recognized as important circulating effector cells in the pathophysiology of severe coronavirus disease 2019 (COVID-19). However, their role within the inflamed lungs is incompletely understood. Here, we collected bronchoalveolar lavage (BAL) fluids and parallel blood samples of critically ill COVID-19 patients requiring invasive mechanical ventilation and compared BAL fluid parameters with those of mechanically ventilated patients with influenza, as a non-COVID-19 viral pneumonia cohort. Compared with those of patients with influenza, BAL fluids of patients with COVID-19 contained increased numbers of hyperactivated degranulating neutrophils and elevated concentrations of the cytokines IL-1ß, IL-1RA, IL-17A, TNF-α, and G-CSF; the chemokines CCL7, CXCL1, CXCL8, CXCL11, and CXCL12α; and the protease inhibitors elafin, secretory leukocyte protease inhibitor, and tissue inhibitor of metalloproteinases 1. In contrast, α-1 antitrypsin levels and net proteolytic activity were comparable in COVID-19 and influenza BAL fluids. During antibiotic treatment for bacterial coinfections, increased BAL fluid levels of several activating and chemotactic factors for monocytes, lymphocytes, and NK cells were detected in patients with COVID-19 whereas concentrations tended to decrease in patients with influenza, highlighting the persistent immunological response to coinfections in COVID-19. Finally, the high proteolytic activity in COVID-19 lungs suggests considering protease inhibitors as a treatment option.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Bacterial Infections / Bronchoalveolar Lavage Fluid / Influenza, Human / Coinfection / COVID-19 Type of study: Diagnostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Year: 2022 Document Type: Article Affiliation country: Jci.insight.155055

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Bacterial Infections / Bronchoalveolar Lavage Fluid / Influenza, Human / Coinfection / COVID-19 Type of study: Diagnostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Year: 2022 Document Type: Article Affiliation country: Jci.insight.155055