Longitudinal assessment of IFN-I activity and immune profile in critically ill COVID-19 patients with acute respiratory distress syndrome.
ARDS
COVID-19
Immune profile
Immunosuppression
Type-I IFN
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
12 04 2021
12 04 2021
Historique:
received:
27
01
2021
accepted:
30
03
2021
entrez:
13
4
2021
pubmed:
14
4
2021
medline:
20
4
2021
Statut:
epublish
Résumé
Since the onset of the pandemic, only few studies focused on longitudinal immune monitoring in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) whereas their hospital stay may last for several weeks. Consequently, the question of whether immune parameters may drive or associate with delayed unfavorable outcome in these critically ill patients remains unsolved. We present a dynamic description of immuno-inflammatory derangements in 64 critically ill COVID-19 patients including plasma IFNα2 levels and IFN-stimulated genes (ISG) score measurements. ARDS patients presented with persistently decreased lymphocyte count and mHLA-DR expression and increased cytokine levels. Type-I IFN response was initially induced with elevation of IFNα2 levels and ISG score followed by a rapid decrease over time. Survivors and non-survivors presented with apparent common immune responses over the first 3 weeks after ICU admission mixing gradual return to normal values of cellular markers and progressive decrease of cytokines levels including IFNα2. Only plasma TNF-α presented with a slow increase over time and higher values in non-survivors compared with survivors. This paralleled with an extremely high occurrence of secondary infections in COVID-19 patients with ARDS. Occurrence of ARDS in response to SARS-CoV2 infection appears to be strongly associated with the intensity of immune alterations upon ICU admission of COVID-19 patients. In these critically ill patients, immune profile presents with similarities with the delayed step of immunosuppression described in bacterial sepsis.
Sections du résumé
BACKGROUND
Since the onset of the pandemic, only few studies focused on longitudinal immune monitoring in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) whereas their hospital stay may last for several weeks. Consequently, the question of whether immune parameters may drive or associate with delayed unfavorable outcome in these critically ill patients remains unsolved.
METHODS
We present a dynamic description of immuno-inflammatory derangements in 64 critically ill COVID-19 patients including plasma IFNα2 levels and IFN-stimulated genes (ISG) score measurements.
RESULTS
ARDS patients presented with persistently decreased lymphocyte count and mHLA-DR expression and increased cytokine levels. Type-I IFN response was initially induced with elevation of IFNα2 levels and ISG score followed by a rapid decrease over time. Survivors and non-survivors presented with apparent common immune responses over the first 3 weeks after ICU admission mixing gradual return to normal values of cellular markers and progressive decrease of cytokines levels including IFNα2. Only plasma TNF-α presented with a slow increase over time and higher values in non-survivors compared with survivors. This paralleled with an extremely high occurrence of secondary infections in COVID-19 patients with ARDS.
CONCLUSIONS
Occurrence of ARDS in response to SARS-CoV2 infection appears to be strongly associated with the intensity of immune alterations upon ICU admission of COVID-19 patients. In these critically ill patients, immune profile presents with similarities with the delayed step of immunosuppression described in bacterial sepsis.
Identifiants
pubmed: 33845874
doi: 10.1186/s13054-021-03558-w
pii: 10.1186/s13054-021-03558-w
pmc: PMC8040759
doi:
Substances chimiques
Biomarkers
0
IFNA2 protein, human
0
Interferon-alpha
0
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
140Investigateurs
Remi Pescarmona
(R)
Lorna Garnier
(L)
Christine Lombard
(C)
Magali Perret
(M)
Marine Villard
(M)
Valérie Cheynet
(V)
Filippo Conti
(F)
Marie Groussaud
(M)
Marielle Buisson
(M)
Laetitia Itah
(L)
Inesse Boussaha
(I)
Françoise Poitevin-Later
(F)
Christophe Malcus
(C)
Morgane Gossez
(M)
Florent Wallet
(F)
Marie-Charlotte Delignette
(MC)
Frederic Dailler
(F)
Marie Simon
(M)
Auguste Dargent
(A)
Pierre-Jean Bertrand
(PJ)
Neven Stevic
(N)
Marion Provent
(M)
Laurie Bignet
(L)
Valérie Cerro
(V)
Jean-Christophe Richard
(JC)
Laurent Bitker
(L)
Mehdi Mezidi
(M)
Loredana Baboi
(L)
Références
Lancet Rheumatol. 2020 Oct;2(10):e594-e602
pubmed: 32864628
Cytokine. 2019 Jan;113:446-452
pubmed: 30413290
Crit Care. 2020 Jul 6;24(1):394
pubmed: 32631393
Intensive Care Med. 2020 Sep;46(9):1764-1765
pubmed: 32488343
Nat Med. 2020 Oct;26(10):1623-1635
pubmed: 32807934
Aging Clin Exp Res. 2021 Mar;33(3):729-732
pubmed: 31522388
Intensive Care Med. 2020 Sep;46(9):1769-1771
pubmed: 32514592
Cell. 2021 Feb 18;184(4):861-880
pubmed: 33497610
Crit Care. 2020 Dec 14;24(1):691
pubmed: 33317616
Viral Immunol. 2020 Apr 10;:
pubmed: 32297828
Cytometry B Clin Cytom. 2013 Jan-Feb;84(1):59-62
pubmed: 22987669
Nat Rev Immunol. 2013 Dec;13(12):862-74
pubmed: 24232462
Front Med (Lausanne). 2020 Aug 05;7:420
pubmed: 32850912
Crit Care. 2020 May 26;24(1):263
pubmed: 32456696
J Clin Invest. 2020 Oct 1;130(10):5235-5244
pubmed: 32634129
Nat Rev Immunol. 2020 Jul;20(7):397-398
pubmed: 32457522
Lancet Respir Med. 2020 Sep;8(9):e70
pubmed: 32771081
Crit Care. 2020 Oct 16;24(1):610
pubmed: 33066801
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
Cell. 2020 Nov 12;183(4):996-1012.e19
pubmed: 33010815
Lancet Respir Med. 2020 Oct;8(10):946-949
pubmed: 32444269
Cytometry B Clin Cytom. 2017 Nov;92(6):456-464
pubmed: 26804473
J Allergy Clin Immunol. 2020 Jul;146(1):206-208.e2
pubmed: 32360285
Clin Infect Dis. 2020 Aug 08;:
pubmed: 32770223
JAMA Intern Med. 2020 Sep 1;180(9):1152-1154
pubmed: 32602883
Med Mycol. 2021 Jan 4;59(1):110-114
pubmed: 32914189
Cytometry A. 2020 Aug;97(8):772-776
pubmed: 32542842
Clin Infect Dis. 2020 Jul 28;:
pubmed: 32720678
Nat Rev Nephrol. 2018 Feb;14(2):121-137
pubmed: 29225343
Nat Commun. 2020 Oct 30;11(1):5493
pubmed: 33127906
Am J Respir Crit Care Med. 2020 Jun 1;201(11):1435-1438
pubmed: 32293905
Intensive Care Med. 2021 Jan;47(1):60-73
pubmed: 33211135
Clin Chem. 2020 Jun 1;66(6):802-808
pubmed: 32359149
Lancet Respir Med. 2020 Dec;8(12):1209-1218
pubmed: 32861275
Science. 2020 Oct 23;370(6515):
pubmed: 32972996
Cytometry A. 2021 Feb 5;:
pubmed: 33547747
Intensive Care Med. 2012 Oct;38(10):1573-82
pubmed: 22926653
Ann Intensive Care. 2020 Dec 10;10(1):167
pubmed: 33301059
Cytometry A. 2020 Dec;97(12):1217-1221
pubmed: 33125816
Cell Mol Immunol. 2020 May;17(5):533-535
pubmed: 32203188
J Med Virol. 2020 Nov;92(11):2283-2285
pubmed: 32343429
Emerg Infect Dis. 2021 Jan;27(1):
pubmed: 33084566
Sci China Life Sci. 2020 Mar;63(3):364-374
pubmed: 32048163
Nature. 2020 Aug;584(7821):463-469
pubmed: 32717743
Cell. 2020 Sep 17;182(6):1419-1440.e23
pubmed: 32810438
Cell. 2020 Sep 17;182(6):1401-1418.e18
pubmed: 32810439
Clin Infect Dis. 2020 Jul 28;:
pubmed: 32719848
Clin Infect Dis. 2020 Aug 17;:
pubmed: 32803231
Lancet Respir Med. 2020 Dec;8(12):1233-1244
pubmed: 33075298
Cell. 2020 May 28;181(5):1036-1045.e9
pubmed: 32416070
Immunity. 2020 Oct 13;53(4):864-877.e5
pubmed: 32791036
Cell Mol Immunol. 2020 May;17(5):541-543
pubmed: 32203186
Ann Transl Med. 2020 May;8(10):629
pubmed: 32566566
Science. 2020 Sep 4;369(6508):1210-1220
pubmed: 32788292
JCI Insight. 2020 Sep 3;5(17):
pubmed: 32687484
J Exp Med. 2020 Jun 1;217(6):
pubmed: 32353870
Ann Transl Med. 2020 Sep;8(18):1145
pubmed: 33240994
J Intensive Care. 2020 May 24;8:36
pubmed: 32483488
Nat Med. 2020 Oct;26(10):1636-1643
pubmed: 32839624
Science. 2020 Aug 7;369(6504):718-724
pubmed: 32661059