Comparative immune profiling of acute respiratory distress syndrome patients with or without SARS-CoV-2 infection

• Published in: Cell reports. Medicine Vol. 2; no. 6; p. 100291
• Main Authors: Roussel, Mikael, Ferrant, Juliette, Reizine, Florian, Le Gallou, Simon, Dulong, Joelle, Carl, Sarah, Lesouhaitier, Matheiu, Gregoire, Murielle, Bescher, Nadège, Verdy, Clotilde, Latour, Maelle, Bézier, Isabelle, Cornic, Marie, Vinit, Angélique, Monvoisin, Céline, Sawitzki, Birgit, Leonard, Simon, Paul, Stéphane, Feuillard, Jean, Jeannet, Robin, Daix, Thomas, Tiwari, Vijay K., Tadié, Jean Marc, Cogné, Michel, Tarte, Karin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.06.2021; Elsevier
• Subjects: Aged; Cohort Studies; COVID-19 - complications; COVID-19 - pathology; COVID-19 - virology; Evolution, Molecular; Female; HLA-DR Antigens - metabolism; Humans; Intensive Care Units; Leukocytes, Mononuclear - cytology; Leukocytes, Mononuclear - immunology; Leukocytes, Mononuclear - metabolism; Lipopolysaccharide Receptors - metabolism; Machine Learning; Male; Middle Aged; Monocytes - cytology; Monocytes - immunology; Monocytes - metabolism; Respiratory Distress Syndrome - etiology; Respiratory Distress Syndrome - immunology; Respiratory Distress Syndrome - pathology; SARS-CoV-2 - isolation & purification; Sialic Acid Binding Ig-like Lectin 1 - metabolism; Th1 Cells - cytology; Th1 Cells - immunology; Th1 Cells - metabolism
• ISSN: 2666-3791; 2666-3791
• DOI: 10.1016/j.xcrm.2021.100291

Acute respiratory distress syndrome (ARDS) is the main complication of coronavirus disease 2019 (COVID-19), requiring admission to the intensive care unit (ICU). Despite extensive immune profiling of COVID-19 patients, to what extent COVID-19-associated ARDS differs from other causes of ARDS remains unknown. To address this question, here, we build 3 cohorts of patients categorized in COVID-19−ARDS+, COVID-19+ARDS+, and COVID-19+ARDS−, and compare, by high-dimensional mass cytometry, their immune landscape. A cell signature associating S100A9/calprotectin-producing CD169+ monocytes, plasmablasts, and Th1 cells is found in COVID-19+ARDS+, unlike COVID-19−ARDS+ patients. Moreover, this signature is essentially shared with COVID-19+ARDS− patients, suggesting that severe COVID-19 patients, whether or not they experience ARDS, display similar immune profiles. We show an increase in CD14+HLA-DRlow and CD14lowCD16+ monocytes correlating to the occurrence of adverse events during the ICU stay. We demonstrate that COVID-19-associated ARDS displays a specific immune profile and may benefit from personalized therapy in addition to standard ARDS management. [Display omitted] Machine-learning analysis of CyTOF data segregates COVID-19+ and COVID-19− ARDSCD169+S100A9+ monocytes differentiate COVID-19 ARDS from other ARDSMonocyte compartment alterations correlate with other immune subset modificationsCD14+HLA-DRlow and CD14loCD16+ monocytes are markers of adverse COVID-19 evolution Roussel et al. characterize the immune profile of COVID-19+ and COVID-19− patients, both presenting an acute respiratory distress syndrome (ARDS) and COVID-19+ without ARDS. They identify a COVID-19 signature associating CD169+S100A9+ monocytes, plasmablasts, and Th1 cells. CD14+HLA-DRlo and CD14loCD16+ monocytes increase during the ICU stay, correlating with an unfavorable clinical course.