Low BALF CD4 T cells count is associated with extubation failure and mortality in critically ill covid-19 pneumonia.
BALF CD4 T-cells count
Critically ill COVID-19 pneumonia
extubation failure
Journal
Annals of medicine
ISSN: 1365-2060
Titre abrégé: Ann Med
Pays: England
ID NLM: 8906388
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
entrez:
5
7
2022
pubmed:
6
7
2022
medline:
8
7
2022
Statut:
ppublish
Résumé
Critically ill COVID-19 pneumonia is one of the main causes of extubation failure and mortality. Understanding clinical characteristics, laboratory profiles and bronchoalveolar lavage fluid (BALF) immunopathology may help improve outcomes in critically ill COVID-19 pneumonia. We aimed to describe clinical characteristics, laboratory profiles and BALF immunopathology based on lung severity in critically ill COVID-19 pneumonia patients. Forty critically ill severe pneumonia patients requiring invasive mechanical ventilation in Cipto Mangunkusumo General (National Tertiary Referral Hospital), Indonesia within November 2020-January 2021 were enrolled in this study. Early BALF collection was performed after patients' intubation. Clinical characteristics, laboratory profiles and BALF biomarkers (sTREM-1, alveolar macrophage amount and function, IL-6, IL-17, CD4 T-cells, Tregs, SP-A and Caspase-3) were observed and analysed. Outcomes were measured based on extubation failure (within 19 days) and 28-days mortality. Univariate and bivariate analyses were performed. Early bronchoscopy was performed in an average of 4 h (SD = 0.82) after patients' intubation. Twenty-three and twenty-two patients had extubation failure (within 19 days) and 28-days mortality, respectively. In the baseline clinical characteristics of critically ill COVID-19 patients, we found no significant differences in the extubation and mortality status groups. In the laboratory profiles of critically ill COVID-19 patients, we found no significant differences in the extubation status groups. In critically ill COVID-19 pneumonia patients, there was a significant high D-dimer levels in survived group ( BALF CD4 T-cells count evaluation of severely affected lung is associated with early extubation failure and mortality in critically ill COVID-19 pneumonia patients. KEY MESSAGEFew studies have been conducted during the peak COVID-19 period analysing combined bronchoalveolar lavage fluid (BALF) immunopathology biomarkers within four hours of intubation to assess extubation failure and mortality. In this study, we reported eight BALF immunopathology biomarkers (sTREM-1, alveolar macrophage, IL-6, IL-17, CD4 T-cells, Tregs, SP-A and Caspase-3).We found significantly low BALF CD4 T-cells count in the right lung, and low BALF CD4 T-cells count in severely affected lung of critically ill COVID-19 pneumonia patients in extubation failure and mortality.
Sections du résumé
BACKGROUND
Critically ill COVID-19 pneumonia is one of the main causes of extubation failure and mortality. Understanding clinical characteristics, laboratory profiles and bronchoalveolar lavage fluid (BALF) immunopathology may help improve outcomes in critically ill COVID-19 pneumonia. We aimed to describe clinical characteristics, laboratory profiles and BALF immunopathology based on lung severity in critically ill COVID-19 pneumonia patients.
MATERIALS AND METHODS
Forty critically ill severe pneumonia patients requiring invasive mechanical ventilation in Cipto Mangunkusumo General (National Tertiary Referral Hospital), Indonesia within November 2020-January 2021 were enrolled in this study. Early BALF collection was performed after patients' intubation. Clinical characteristics, laboratory profiles and BALF biomarkers (sTREM-1, alveolar macrophage amount and function, IL-6, IL-17, CD4 T-cells, Tregs, SP-A and Caspase-3) were observed and analysed. Outcomes were measured based on extubation failure (within 19 days) and 28-days mortality. Univariate and bivariate analyses were performed.
RESULTS
Early bronchoscopy was performed in an average of 4 h (SD = 0.82) after patients' intubation. Twenty-three and twenty-two patients had extubation failure (within 19 days) and 28-days mortality, respectively. In the baseline clinical characteristics of critically ill COVID-19 patients, we found no significant differences in the extubation and mortality status groups. In the laboratory profiles of critically ill COVID-19 patients, we found no significant differences in the extubation status groups. In critically ill COVID-19 pneumonia patients, there was a significant high D-dimer levels in survived group (
CONCLUSIONS
BALF CD4 T-cells count evaluation of severely affected lung is associated with early extubation failure and mortality in critically ill COVID-19 pneumonia patients. KEY MESSAGEFew studies have been conducted during the peak COVID-19 period analysing combined bronchoalveolar lavage fluid (BALF) immunopathology biomarkers within four hours of intubation to assess extubation failure and mortality. In this study, we reported eight BALF immunopathology biomarkers (sTREM-1, alveolar macrophage, IL-6, IL-17, CD4 T-cells, Tregs, SP-A and Caspase-3).We found significantly low BALF CD4 T-cells count in the right lung, and low BALF CD4 T-cells count in severely affected lung of critically ill COVID-19 pneumonia patients in extubation failure and mortality.
Identifiants
pubmed: 35786088
doi: 10.1080/07853890.2022.2095012
pmc: PMC9258432
doi:
Substances chimiques
Biomarkers
0
Interleukin-17
0
Interleukin-6
0
Caspase 3
EC 3.4.22.-
Banques de données
UMIN-CTR
['UMIN000046236']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1894-1905Références
Br Med Bull. 2002;61:45-61
pubmed: 11997298
Intern Emerg Med. 2020 Oct;15(7):1333-1334
pubmed: 32415560
Open Med (Wars). 2021 Aug 09;16(1):1132-1133
pubmed: 34435137
Eur Respir J. 2010 Jan;35(1):88-94
pubmed: 19541716
Crit Care Med. 1999 Sep;27(9):1745-53
pubmed: 10507593
J Vis Exp. 2018 Apr 20;(134):
pubmed: 29733312
Mol Med Rep. 2017 Dec;16(6):9601-9606
pubmed: 29039549
Sci Rep. 2020 Dec 22;10(1):22369
pubmed: 33353956
Infect Immun. 1998 Jul;66(7):3164-9
pubmed: 9632581
BMC Pulm Med. 2020 Nov 16;20(1):301
pubmed: 33198751
Br J Radiol. 2010 Dec;83(996):998-1009
pubmed: 21088086
Thorax. 2021 Oct;76(10):1010-1019
pubmed: 33846275
N Engl J Med. 2004 Jan 29;350(5):451-8
pubmed: 14749453
Radiology. 2020 Aug;296(2):E72-E78
pubmed: 32216717
Nat Immunol. 2005 Nov;6(11):1133-41
pubmed: 16200068
BMC Pulm Med. 2021 Jun 9;21(1):196
pubmed: 34107929
Nat Med. 2020 Jun;26(6):842-844
pubmed: 32398875
Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72
pubmed: 17278083
Inflammation. 2014 Aug;37(4):1158-66
pubmed: 24557760
JCI Insight. 2020 Feb 27;5(4):
pubmed: 31990682
Int J Biol Sci. 2021 Apr 10;17(6):1507-1520
pubmed: 33907514
Arch Immunol Ther Exp (Warsz). 2018 Aug;66(4):299-306
pubmed: 29282483
Clin Dev Immunol. 2013;2013:267971
pubmed: 23956759
Am Rev Respir Dis. 1993 Mar;147(3):653-7
pubmed: 8442601
Hum Pathol. 2021 Jul;113:92-103
pubmed: 33905777
Shock. 2016 Aug;46(2):164-72
pubmed: 26849628
Eur Respir J. 2013 Jun;41(6):1378-85
pubmed: 23258791
Infect Immun. 2002 Sep;70(9):5019-25
pubmed: 12183548
J Thorac Dis. 2020 Sep;12(9):4991-5019
pubmed: 33145073
J Intensive Care. 2020 Oct 15;8:80
pubmed: 33078076
Innate Immun. 2016 Nov;22(8):620-625
pubmed: 27634821
Am J Pathol. 1979 Oct;97(1):149-206
pubmed: 495693
Diagnosis (Berl). 2020 Nov 18;7(4):365-372
pubmed: 32589600
PLoS Pathog. 2018 May 29;14(5):e1007099
pubmed: 29813133
J Epidemiol Glob Health. 2021 Mar;11(1):98-104
pubmed: 33095982
PLoS Pathog. 2012;8(4):e1002660
pubmed: 22563306
BMC Infect Dis. 2021 Mar 20;21(1):283
pubmed: 33740907
BMC Infect Dis. 2021 Apr 15;21(1):353
pubmed: 33858331
Scand J Immunol. 2009 Oct;70(4):326-36
pubmed: 19751267
Front Immunol. 2020 Jun 16;11:1441
pubmed: 32612615
Intensive Care Med. 2013 Oct;39(10):1743-51
pubmed: 23949701
Medicine (Baltimore). 2021 Jan 8;100(1):e24256
pubmed: 33429831
Chest. 1995 May;107(5):1342-9
pubmed: 7750329
Ann Am Thorac Soc. 2021 Apr;18(4):723-726
pubmed: 33233944
Jpn J Infect Dis. 2011;64(6):451-7
pubmed: 22116322
PLoS One. 2017 Aug 14;12(8):e0182966
pubmed: 28806403
Crit Care. 2008;12(1):R6
pubmed: 18205941
Int J Infect Dis. 2020 Jul;96:467-474
pubmed: 32425643
Mucosal Immunol. 2014 Nov;7(6):1440-51
pubmed: 24850425
J Intensive Care Med. 2021 Sep;36(9):1018-1024
pubmed: 34074160
J Intensive Care. 2020 Jul 10;8:49
pubmed: 32665858
Biosci Rep. 2020 Feb 28;40(2):
pubmed: 31990295
Thorax. 2011 May;66(5):375-82
pubmed: 21357587
Am J Respir Crit Care Med. 2003 Jan 15;167(2):171-9
pubmed: 12406830
Arch Med Res. 2020 Jul;51(5):429-435
pubmed: 32402575
J Immunol. 2012 May 1;188(9):4376-84
pubmed: 22474025
Am J Respir Crit Care Med. 2021 May 15;203(10):1211-1212
pubmed: 33503397
Indian J Otolaryngol Head Neck Surg. 2010 Jun;62(2):168-70
pubmed: 23120706
Crit Care. 2011;15(1):R50
pubmed: 21294874
Front Physiol. 2018 Aug 02;9:877
pubmed: 30127748
PLoS One. 2013 May 29;8(5):e65436
pubmed: 23734253
J Transl Med. 2020 Nov 11;18(1):427
pubmed: 33176790
PLoS One. 2020 Nov 23;15(11):e0242651
pubmed: 33227024
EClinicalMedicine. 2020 Aug;25:100449
pubmed: 32838231
Thorax. 1991 Sep;46(9):658-62
pubmed: 1948795
PLoS One. 2014 Apr 04;9(4):e93885
pubmed: 24705783
Front Med. 2017 Jun;11(2):169-177
pubmed: 28425045
PLoS One. 2021 Jul 13;16(7):e0254550
pubmed: 34255793
Clin Immunol. 2015 Aug;159(2):177-82
pubmed: 26122174