CHRONIC INFLAMMATION MIGHT PROTECT HAEMODIALYSIS PATIENTS FROM SEVERE COVID-19
Nephrology Dialysis Transplantation
; 37(SUPPL 3):i106, 2022.
Article
in English
| EMBASE | ID: covidwho-1915671
ABSTRACT
BACKGROUND AND AIMS:
Patients on haemodialysis (HD) are expected to have excess mortality in coronavirus disease 2019 (COVID-19). This was challenged by a recent study reporting HD patients to have comparable mortality and decreased ICU admissions when hospitalized with COVID-19. It was speculated that an altered immune system due to chronic inflammation might protect HD patients from severe COVID-19. Therefore, we designed a study to describe the peripheral blood immune phenotype in HD patients and respective controls with COVID-19.METHOD:
Sixty-four patients (31 HD, 33 non-HD) with PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and 16 control patients (10 HD, 6 non-HD) were prospectively included. According to symptoms, COVID-19 patients were categorized as asymptomatic/mild and moderate/severe COVID-19 phenotypes. Cytokine profiling and immune phenotyping were performed.RESULTS:
Th1 and Th17 plasma cytokine levels were highly increased in HD patients without SARS-CoV-2 infection and were not significantly regulated during COVID-19. In non-HD COVID-19 patients, these cytokines increased significantly with disease severity. While all patients with moderate/severe COVID-19 showed hallmarks of COVID-19 such as decreased CD3+, CD4+ and CD8+ and CD4+CD25hiFoxP3+ regulatory T cells, significantly increased CD38+CD8+ effector memory and CD38+CD8+ TEMRA T cells were detected in HD compared to non-HD patients with moderate/severe COVID-19. Furthermore, CD161+CD8+ T cells decreased significantly in non-HD COVID-19 patients dependent on disease severity, but not in HD patients. Dynamics of B cells and subtypes were comparable in HD and non-HD COVID-19 patients. Significantly fewer moderate/severe COVID-19 HD patients needed ICU treatment [1/13 (7.7%) HD, 12/24 (50%) non-HD], whereas no difference in mortality was observed [4/31 (12.9%) HD, 6/33 non-HD (18.2%)].CONCLUSION:
HD patients might be protected from severe COVID-19 due to their chronic inflammatory state with increased CD38+CD8+ effector memory and TEMRA T cells as well as CD161+CD8+ T cells.
CD3 antigen; CD4 antigen; cytokine; endogenous compound; interleukin 2 receptor alpha; adult; B lymphocyte; CD8+ T lymphocyte; chronic inflammation; conference abstract; controlled study; coronavirus disease 2019; female; gene expression; hemodialysis; hemodialysis patient; human; human cell; human tissue; major clinical study; male; memory; mortality; phenotype; prospective study; protein blood level; protein fingerprinting; regulatory T lymphocyte; T lymphocyte
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Nephrology Dialysis Transplantation
Year:
2022
Document Type:
Article
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