Patients with SARS-CoV-2-Induced Viral Sepsis Simultaneously Show Immune Activation, Impaired Immune Function and a Procoagulatory Disease State
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Ethics
2.3. Cellular Analyzes
2.4. Flow Cytometry
2.5. Multiplex ELISA
2.6. Functional Immunoassays–Stimulation of Monocytes and T Cells
2.7. Phagocytosis Assay (E. coli-pHrodo)
2.8. Isolation and Quantification of Mitochondrial DNA
2.9. Data and Statistical Analysis
3. Results
3.1. Study Population
3.2. Severe COVID-19 Patients Show Increased Granulocyte but Decreased Lymphocyte Numbers
3.3. Higher Concentrations of Pro- and Anti-Inflammatory Mediators in Plasma of Severe COVID-19 Patients
3.4. Higher Concentrations of Pro- and Anti-Inflammatory Soluble Receptors in Plasma of Severe COVID-19 Patients
3.5. Biomarkers Reflecting Organ Dysfunction Are Significantly Upregulated in Severe COVID-19 Patients
3.6. Concentrations of Soluble Pattern Recognition Receptors Are Increased in COVID Patients but Strongly Increased in Plasma of Severe COVID-19 Patients
3.7. Impaired Immune Function of T Cells and Monocytes in Severe COVID-19 Patients
3.8. Impaired Phagocytic Activity of Monocytes and Granulocytes in Severe COVID-19 Patients
3.9. Increased Coagulation and Decreased Fibrinolysis in Severe COVID-19 Patients
3.10. Only Minor Phenotypic and Functional Changes over Time in COVID-19 Patients
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographics | Total (n = 127) | WHO 4–5 (n = 52) | WHO 6–10 (n = 75) | p-Value |
---|---|---|---|---|
Male/Female | 82/45 | 30/22 | 52/23 | 0.1917 $ |
Age (years), median (range) | 61 (19–88) | 61 (21–88) | 62 (19–86) | 0.7021 § |
BMI (kg/m2), median (range) | 27.8 (18.4–52.7) | 25.45 (18.4–39) | 29.2 (20.1–52.7) | 0.0006 § |
Charlson Comorbidity Index, median (range) | 1 (0–9) | 1 (0–9) | 1 (0–9) | 0.1316 § |
SOFA on admission, median (range) | 2 (0–11) | 0 (0–3) | 2 (0–11) | <0.0001 § |
SAPS II on admission, median (range) | 27 (0–54) | 22 (0–28) | 31 (0–54) | <0.0001 § |
GCS, median (range) | 15 (3–15) | 15 (15) | 15 (3–15) | 0.5126 § |
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Limmer, A.; Engler, A.; Kattner, S.; Gregorius, J.; Pattberg, K.T.; Schulz, R.; Schwab, J.; Roth, J.; Vogl, T.; Krawczyk, A.; et al. Patients with SARS-CoV-2-Induced Viral Sepsis Simultaneously Show Immune Activation, Impaired Immune Function and a Procoagulatory Disease State. Vaccines 2023, 11, 435. https://doi.org/10.3390/vaccines11020435
Limmer A, Engler A, Kattner S, Gregorius J, Pattberg KT, Schulz R, Schwab J, Roth J, Vogl T, Krawczyk A, et al. Patients with SARS-CoV-2-Induced Viral Sepsis Simultaneously Show Immune Activation, Impaired Immune Function and a Procoagulatory Disease State. Vaccines. 2023; 11(2):435. https://doi.org/10.3390/vaccines11020435
Chicago/Turabian StyleLimmer, Andreas, Andrea Engler, Simone Kattner, Jonas Gregorius, Kevin Thomas Pattberg, Rebecca Schulz, Jansje Schwab, Johannes Roth, Thomas Vogl, Adalbert Krawczyk, and et al. 2023. "Patients with SARS-CoV-2-Induced Viral Sepsis Simultaneously Show Immune Activation, Impaired Immune Function and a Procoagulatory Disease State" Vaccines 11, no. 2: 435. https://doi.org/10.3390/vaccines11020435