Complex Immunometabolic Profiling Reveals the Activation of Cellular Immunity and Biliary Lesions in Patients with Severe COVID-19
1
Department of Immunology, 2nd Faculty of Medicine, Charles University and University Hospital in Motol, 150 06 Prague, Czech Republic
2
Department of Pediatrics, 1st Faculty of Medicine, Charles University and Thomayer’s Hospital, 140 59 Prague, Czech Republic
3
Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and University Hospital in Motol, 150 06 Prague, Czech Republic
4
Department of Infectious Diseases, University Hospital in Motol, 150 06 Prague, Czech Republic
5
Department of Pneumology, 2nd Faculty of Medicine, Charles University and University Hospital in Motol, 150 06 Prague, Czech Republic
6
Department of Anesthesiology and Intensive Care Medicine, 2nd Faculty of Medicine, Charles University and University Hospital in Motol, 150 06 Prague, Czech Republic
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(9), 3000; https://doi.org/10.3390/jcm9093000
Received: 22 July 2020 / Revised: 4 September 2020 / Accepted: 10 September 2020 / Published: 17 September 2020
(This article belongs to the Special Issue COVID-19: From Pathophysiology to Clinical Practice)
This study aimed to assess the key laboratory features displayed by coronavirus disease 2019 (COVID-19) inpatients that are associated with mild, moderate, severe, and fatal courses of the disease, and through a longitudinal follow-up, to understand the dynamics of the COVID-19 pathophysiology. All severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients admitted to the University Hospital in Motol between March and June 2020 were included in this study. A severe course of COVID-19 was associated with an elevation of proinflammatory markers; an efflux of immature granulocytes into peripheral blood; the activation of CD8 T cells, which infiltrated the lungs; transient liver disease. In particular, the elevation of serum gamma-glutamyl transferase (GGT) and histological signs of cholestasis were highly specific for patients with a severe form of the disease. In contrast, patients with a fatal course of COVID-19 failed to upregulate markers of inflammation, showed discoordination of the immune response, and progressed toward acute kidney failure. COVID-19 is a disease with a multi-organ affinity that is characterized by the activation of innate and cellular adaptive immunity. Biliary lesions with an elevation of GGT and the organ infiltration of interleukin 6 (IL-6)-producing cells are the defining characteristics for patients with the fulminant disease.
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Keywords:
COVID-19; SARS-CoV-2; immunity; T cells; IL-6; GGT; hepatopathy; biliary lesion; acute kidney injury; liver disease
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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MDPI and ACS Style
Klocperk, A.; Bloomfield, M.; Parackova, Z.; Zentsova, I.; Vrabcova, P.; Balko, J.; Meseznikov, G.; Casas Mendez, L.F.; Grandcourtova, A.; Sipek, J.; Tulach, M.; Zamecnik, J.; Vymazal, T.; Sediva, A. Complex Immunometabolic Profiling Reveals the Activation of Cellular Immunity and Biliary Lesions in Patients with Severe COVID-19. J. Clin. Med. 2020, 9, 3000.
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