Chronic Inflammation Might Protect Hemodialysis Patients From Severe COVID-19

Frontiers in Immunology

Stefanie Stanzer¹  Marianne Brodmann²  Verena Pfeifer³  Barbara Prietl³  Thomas Pieber³  Alexander H. Kirsch⁴  Balazs Odler⁴  Katharina Artinger⁴  Alexander R. Rosenkranz⁴  Kathrin Eller⁴  Anita Eberl⁵  Reingard Raml⁵  Philipp Eller⁶  Manfred Eigner⁷  Sabine Schmaldienst⁷ 

[1] Center for Biomarker Research in Medicine, Graz, Austria;Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbH, Graz, Austria;Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Klinikum Favoriten, Wiener Krankenanstaltenverbund, Vienna, Austria;

关键词: inflammation;    COVID-19;    hemodialysis patients;    CD8+ T cells;    cytokines;   

DOI  :  10.3389/fimmu.2022.821818

来源: DOAJ

【 摘 要 】

Hemodialysis patients (HD) are expected to have excess mortality in coronavirus disease 2019 (COVID-19). This was challenged by a recent study reporting HD patients to have comparable mortality and less ICU admissions when hospitalized with COVID-19. An altered immune system due to chronic inflammation might protect HD-patients from severe COVID-19. Therefore, we aimed to describe the peripheral blood immune phenotype in HD-patients and respective controls with COVID-19.MethodsSixty-four patients (31 HD, 33 non-HD) with PCR-confirmed COVID-19 and 16 control patients (10 HD, 6 non-HD) were prospectively included. According to symptoms, COVID-19 patients were categorized as asymptomatic/mild, moderate or severe COVID-19 phenotypes. Cytokine profiling and immune phenotyping was performed.ResultsTh1 and Th17 plasma cytokine levels were highly increased in HD patients without COVID-19 and were not significantly regulated during COVID-19. In non-HD COVID-19 patients these cytokines increased significantly with disease severity. While all patients with moderate or severe COVID-19 showed hallmarks of COVID-19 such as decreased CD3+, CD4+ and CD8+ and CD4+CD25hiFoxP3+ regulatory T cells, significantly increased CD38+CD8+ effector memory and CD38+CD8+ TEMRA T cells were detected in moderate/severe COVID-19 HD patients, which was not observed in non-HD patients with moderate or severe COVID-19. Furthermore, CD161+CD8+ T cells decreased significantly in non-HD COVID-19 patients dependent on disease severity, but not in HD patients. Dynamics of B cells and subtypes were comparable in HD and non-HD COVID-19 patients.ConclusionsHD patients might be protected from severe COVID-19 due to their chronic inflammatory state with increased CD38+CD8+ effector memory and TEMRA T cells as well as CD161+CD8+ T cells.

【 授权许可】

Unknown