Abstract
Background: The pathogenesis of coronavirus disease 2019 (COVID-19) is still incompletely understood, but it seems to involve immune activation and immune dysregulation.
Objective: We examined the parameters of activation of different leukocyte subsets in COVID-19-infected patients in relation to disease severity.
Methods: We analyzed plasma levels of myeloperoxidase (a marker of neutrophil activation), soluble (s) CD25 (sCD25) and soluble T-cell immunoglobulin mucin domain-3 (sTIM-3) (markers of T-cell activation and exhaustion), and sCD14 and sCD163 (markers of monocyte/macrophage activation) in 39 COVID-19-infected patients at hospital admission and 2 additional times during the first 10 days in relation to their need for intensive care unit (ICU) treatment.
Results: Our major findings were as follows: (1) severe clinical outcome (ICU treatment) was associated with high plasma levels of sTIM-3 and myeloperoxidase, suggesting activated and potentially exhausted T cells and activated neutrophils, respectively; (2) in contrast, sCD14 and sCD163 showed no association with need for ICU treatment; and (3) levels of sCD25, sTIM-3, and myeloperoxidase were inversely correlated with degree of respiratory failure, as assessed by the ratio of Pao 2 to fraction of inspired oxygen, and were positively correlated with the cardiac marker N-terminal pro-B-type natriuretic peptide.
Conclusion: Our findings suggest that neutrophil activation and, in particular, activated T cells may play an important role in the pathogenesis of COVID-19 infection, suggesting that T-cell-targeted treatment options and downregulation of neutrophil activation could be of importance in this disorder.
Keywords: COVID-19; T cell; TIM-3; neutrophil; outcome.
【저자키워드】 COVID-19, neutrophil, TIM-3, outcome, T cell, 【초록키워드】 Treatment, coronavirus disease, Neutrophils, Coronavirus disease 2019, Pathogenesis, Respiratory failure, intensive care, T cells, disease severity, neutrophil, Infection, intensive care unit, peptide, oxygen, outcome, ICU, monocyte, Clinical outcome, T cell, Immunoglobulin, COVID-19 infection, immune activation, Patient, Exhaustion, plasma, Hospital admission, T-cell, mucin, CD25, macrophage activation, association, marker, myeloperoxidase, Activated neutrophils, Plasma levels, neutrophil activation, immune dysregulation, dysregulation, leukocyte, Activation, ICU treatment, pathogenesis of COVID-19, fraction, downregulation, disorder, activated T cells, high plasma levels, N-terminal pro-B-type natriuretic peptide, T-cell activation, parameter, N-terminal, analyzed, examined, activated, correlated, subset, activated T cell, high plasma level, positively correlated, pro-B-type natriuretic peptide, 【제목키워드】 severe COVID-19, Patient, plasma,