Immune Alterations in a Patient with SARS-CoV-2-Related Acute Respiratory Distress Syndrome.
J Clin Immunol
; 40(8): 1082-1092, 2020 11.
Article
in English
| MEDLINE | ID: covidwho-724903
ABSTRACT
We report a longitudinal analysis of the immune response associated with a fatal case of COVID-19 in Europe. This patient exhibited a rapid evolution towards multiorgan failure. SARS-CoV-2 was detected in multiple nasopharyngeal, blood, and pleural samples, despite antiviral and immunomodulator treatment. Clinical evolution in the blood was marked by an increase (2-3-fold) in differentiated effector T cells expressing exhaustion (PD-1) and senescence (CD57) markers, an expansion of antibody-secreting cells, a 15-fold increase in γδ T cell and proliferating NK-cell populations, and the total disappearance of monocytes, suggesting lung trafficking. In the serum, waves of a pro-inflammatory cytokine storm, Th1 and Th2 activation, and markers of T cell exhaustion, apoptosis, cell cytotoxicity, and endothelial activation were observed until the fatal outcome. This case underscores the need for well-designed studies to investigate complementary approaches to control viral replication, the source of the hyperinflammatory status, and immunomodulation to target the pathophysiological response. The investigation was conducted as part of an overall French clinical cohort assessing patients with COVID-19 and registered in clinicaltrials.gov under the following number NCT04262921.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Respiratory Distress Syndrome
/
Coronavirus Infections
/
Betacoronavirus
/
Cytokine Release Syndrome
/
Multiple Organ Failure
Type of study:
Case report
/
Cohort study
/
Observational study
/
Prognostic study
Topics:
Long Covid
Country/Region as subject:
Europa
Language:
English
Journal:
J Clin Immunol
Year:
2020
Document Type:
Article
Affiliation country:
S10875-020-00839-x
Similar
MEDLINE
...
LILACS
LIS