Background The major histocompatibility complex (MHC) class II characterized by monocytes CD14+ expression of human leukocyte antigen receptors (HLA-DR), is essential for the synapse between innate and adaptive immune response in infectious disease. Its reduced expression is associated with a high risk of secondary infections in septic patients and can be safely corrected by Interferon-y (IFNy) injection. Coronavirus disease (COVID-19) induces an alteration of Interferon (IFN) genes expression potentially responsible for the observed low HLA-DR expression in circulating monocytes (mHLA-DR). Methods We report a case of one-time INFy injection (100 mcg s.c.) in a superinfected 61-year-old man with COVID-19–associated acute respiratory distress syndrome (ARDS), with monitoring of mHLA-DR expression and clinical tolerance. Observations Low mHLA-DR pretreatment expression (26.7%) was observed. IFNy therapy leading to a rapid increase in mHLA-DR expression (83.1%). Conclusions Severe ARDS in a COVID-19 patient has a deep reduction in mHLA-DR expression concomitantly with secondary infections. The unique IFNy injection was safe and led to a sharp increase in the expression of mHLA-DR. Based on immune and infection monitoring, more cases of severe COVID-19 patients with low mHLA-DR should be treated by IFNy to test the clinical effectiveness.
【저자키워드】 COVID-19, SARS-CoV-2, intensive care, acute respiratory distress syndrome, Case report, monocytic human leukocyte antigen receptor, interferon-y, acquired immunosuppression syndrome, 【초록키워드】 Tolerance, ARDS, therapy, Infection, Infectious disease, immune, Antigen, monocyte, Secondary infection, IFN, clinical effectiveness, receptor, Adaptive immune response, disease, expression, HLA-DR, MHC, secondary infections, acute respiratory distress, COVID-19 patient, Safe, high risk, leukocyte, observation, syndrome, injection, rapid increase, CD14+, mHLA-DR, responsible, reduced, characterized, treated, unique, increase in, induce, reduction in, histocompatibility complex, circulating monocyte, septic patient, severe COVID-19 patient, 【제목키워드】 Human, mHLA-DR, Acquired,