Refine
Has Fulltext
- yes (11)
Is part of the Bibliography
- yes (11)
Document Type
- Journal article (11)
Language
- English (11) (remove)
Keywords
- COVID-19 (3)
- acute respiratory distress syndrome (2)
- perioperative care (2)
- postoperative nausea and vomiting (2)
- ARDS (acute respiratory distress syndrome) (1)
- Coronavirus Disease 2019 (1)
- Germany (1)
- Severe Acute Respiratory Syndrome Coronavirus 2 (1)
- acute Respiratory Distress Syndrome (1)
- analgesics (1)
Institute
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (11)
- Medizinische Klinik und Poliklinik I (3)
- Frauenklinik und Poliklinik (2)
- Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) (2)
- Institut für Experimentelle Biomedizin (1)
- Institut für Hygiene und Mikrobiologie (1)
- Institut für Klinische Epidemiologie und Biometrie (1)
- Institut für Virologie und Immunbiologie (1)
- Institut für diagnostische und interventionelle Neuroradiologie (ehem. Abteilung für Neuroradiologie) (1)
- Medizinische Klinik und Poliklinik II (1)
Objectives
The severity of Coronavirus Disease 2019 (COVID-19) is largely determined by the immune response. First studies indicate altered lymphocyte counts and function. However, interactions of pro- and anti-inflammatory mechanisms remain elusive. In the current study we characterized the immune responses in patients suffering from severe COVID-19-induced acute respiratory distress syndrome (ARDS).
Methods
This was a single-center retrospective study in patients admitted to the intensive care unit (ICU) with confirmed COVID-19 between March 14th and May 28th 2020 (n = 39). Longitudinal data were collected within routine clinical care, including flow-cytometry of lymphocyte subsets, cytokine analysis and growth differentiation factor 15 (GDF-15). Antibody responses against the receptor binding domain (RBD) of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike protein were analyzed.
Results
All patients suffered from severe ARDS, 30.8% died. Interleukin (IL)-6 was massively elevated at every time-point. The anti-inflammatory cytokine IL-10 was concomitantly upregulated with IL-6. The cellular response was characterized by lymphocytopenia with low counts of CD8+ T cells, natural killer (NK) and naïve T helper cells. CD8+ T and NK cells recovered after 8 to 14 days. The B cell system was largely unimpeded. This coincided with a slight increase in anti-SARS-CoV-2-Spike-RBD immunoglobulin (Ig) G and a decrease in anti-SARS-CoV-2-Spike-RBD IgM. GDF-15 levels were elevated throughout ICU treatment.
Conclusions
Massively elevated levels of IL-6 and a delayed cytotoxic immune defense characterized severe COVID-19-induced ARDS. The B cell response and antibody production were largely unimpeded. No obvious imbalance of pro- and anti-inflammatory mechanisms was observed, with elevated GDF-15 levels suggesting increased tissue resilience.