Broncho-alveolar inflammation in COVID-19 patients: a correlation with clinical outcome.


Journal

BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563

Informations de publication

Date de publication:
16 Nov 2020
Historique:
received: 28 07 2020
accepted: 09 11 2020
entrez: 17 11 2020
pubmed: 18 11 2020
medline: 20 11 2020
Statut: epublish

Résumé

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly reached pandemic proportions. Given that the main target of SARS-CoV-2 are lungs leading to severe pneumonia with hyperactivation of the inflammatory cascade, we conducted a prospective study to assess alveolar inflammatory status in patients with moderate to severe COVID-19. Diagnostic bronchoalveolar lavage (BAL) was performed in 33 adult patients with SARS-CoV-2 infection by real-time PCR on nasopharyngeal swab admitted to the Intensive care unit (ICU) (n = 28) and to the Intermediate Medicine Ward (IMW) (n = 5). We analyze the differential cell count, ultrastructure of cells and Interleukin (IL)6, 8 and 10 levels. ICU patients showed a marked increase in neutrophils (1.24 × 10 Alveolitis, associated with COVID-19, is mainly sustained by innate effectors which showed features of extensive activation. The burden of pro-inflammatory cytokines IL6 and IL8 in the broncho-alveolar environment is associated with clinical outcome.

Sections du résumé

BACKGROUND BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly reached pandemic proportions. Given that the main target of SARS-CoV-2 are lungs leading to severe pneumonia with hyperactivation of the inflammatory cascade, we conducted a prospective study to assess alveolar inflammatory status in patients with moderate to severe COVID-19.
METHODS METHODS
Diagnostic bronchoalveolar lavage (BAL) was performed in 33 adult patients with SARS-CoV-2 infection by real-time PCR on nasopharyngeal swab admitted to the Intensive care unit (ICU) (n = 28) and to the Intermediate Medicine Ward (IMW) (n = 5). We analyze the differential cell count, ultrastructure of cells and Interleukin (IL)6, 8 and 10 levels.
RESULTS RESULTS
ICU patients showed a marked increase in neutrophils (1.24 × 10
CONCLUSIONS CONCLUSIONS
Alveolitis, associated with COVID-19, is mainly sustained by innate effectors which showed features of extensive activation. The burden of pro-inflammatory cytokines IL6 and IL8 in the broncho-alveolar environment is associated with clinical outcome.

Identifiants

pubmed: 33198751
doi: 10.1186/s12890-020-01343-z
pii: 10.1186/s12890-020-01343-z
pmc: PMC7668012
doi:

Substances chimiques

Adrenal Cortex Hormones 0
Antibodies, Monoclonal, Humanized 0
Antiviral Agents 0
Drug Combinations 0
Interleukin-6 0
Interleukin-8 0
Spike Glycoprotein, Coronavirus 0
lopinavir-ritonavir drug combination 0
spike protein, SARS-CoV-2 0
Interleukin-10 130068-27-8
Lopinavir 2494G1JF75
remdesivir 3QKI37EEHE
Adenosine Monophosphate 415SHH325A
Hydroxychloroquine 4QWG6N8QKH
tocilizumab I031V2H011
Ritonavir O3J8G9O825
Alanine OF5P57N2ZX

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

301

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Auteurs

Laura Pandolfi (L)

Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy. l.pandolfi@smatteo.pv.it.

Tommaso Fossali (T)

Division of Anaesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.

Vanessa Frangipane (V)

Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy.

Sara Bozzini (S)

Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy.

Monica Morosini (M)

Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy.

Maura D'Amato (M)

Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy.

Sara Lettieri (S)

University of Pavia and Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

Mario Urtis (M)

Center for Inherited Cardiovascular Diseases, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.

Alessandro Di Toro (A)

Center for Inherited Cardiovascular Diseases, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.

Laura Saracino (L)

Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

Elena Percivalle (E)

Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

Stefano Tomaselli (S)

Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

Lorenzo Cavagna (L)

Division of Rheumatology, University of Pavia and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

Emanuela Cova (E)

Department of Diagnostic Medicine, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

Francesco Mojoli (F)

Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia, Pavia, Italy.

Paola Bergomi (P)

Division of Anaesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.

Davide Ottolina (D)

Division of Anaesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.

Daniele Lilleri (D)

Laboratories of Genetics, Transplantology and Cardiovascular Diseases, and Biotechnology Laboratories, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.

Angelo Guido Corsico (AG)

University of Pavia and Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

Eloisa Arbustini (E)

Center for Inherited Cardiovascular Diseases, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.

Riccardo Colombo (R)

Division of Anaesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.

Federica Meloni (F)

University of Pavia and Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.

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