COVID-19 patients exhibit less pronounced immune suppression compared with bacterial septic shock patients

• Published in: Critical care (London, England) Vol. 24; no. 1; pp. 263 - 4
• Main Authors: Kox, Matthijs, Frenzel, Tim, Schouten, Jeroen, van de Veerdonk, Frank L., Koenen, Hans J. P. M., Pickkers, Peter
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.05.2020; BioMed Central; BMC
• Subjects: Aged; Betacoronavirus - immunology; Comparative analysis; Coronavirus Infections - immunology; Coronavirus Infections - metabolism; Coronaviruses; COVID; COVID-19; Critical care; Cytokines; EDTA; Exhibitions; Female; HLA-DR; Humans; Immune Tolerance - physiology; Infections; Intensive care; Intensive Care Units - trends; Male; mHLA-DR; Middle Aged; Monocytes; Pandemics; Patients; Pneumonia, Viral - immunology; Pneumonia, Viral - metabolism; Prospective Studies; Research Letter; SARS-CoV-2; Sepsis; Septic shock; Severe acute respiratory syndrome coronavirus 2; Shock, Septic - immunology; Shock, Septic - metabolism; Software; United States > US; Netherlands; China; COVID; COVID-19; Monocytes; SARS-CoV-2; HLA-DR; Immune suppression; mHLA-DR
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1466-609X; 1366-609X
• DOI: 10.1186/s13054-020-02896-5

SEE PDF] Although mHLA-DR expression levels in COVID-19 patients were lower than those observed in healthy subjects (15,000–45,000 mAb/cell [5]), the extent of suppression was less pronounced than observed in bacterial septic shock patients (geometric mean [95% CI] of 11,860 [11,035–12,746] vs. 5211 [4904–5537] mAb/cell, respectively; p < 0.0001; Fig. 1a, sepsis data from [1]). mHLA-DR expression kinetics revealed no change over time (Fig. 1b). SEE PDF] In conclusion, despite a pronounced inflammatory response in COVID-19 patients, our preliminary results indicate more moderate innate immune suppression compared with bacterial septic shock patients. [...]innate immune suppression as a negative feedback mechanism following pathogen-associated molecular pattern-induced inflammation appears less pronounced in COVID-19.