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Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Clin+Immunol 2020 ; 40 (8): 1082-1092 Nephropedia Template TP
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Immune Alterations in a Patient with SARS-CoV-2-Related Acute Respiratory Distress Syndrome #MMPMID32829467
Bouadma L; Wiedemann A; Patrier J; Surenaud M; Wicky PH; Foucat E; Diehl JL; Hejblum BP; Sinnah F; de Montmollin E; Lacabaratz C; Thiebaut R; Timsit JF; Levy Y
J Clin Immunol 2020[Nov]; 40 (8): 1082-1092 PMID32829467show ga
We report a longitudinal analysis of the immune response associated with a fatal case of COVID-19 in Europe. This patient exhibited a rapid evolution towards multiorgan failure. SARS-CoV-2 was detected in multiple nasopharyngeal, blood, and pleural samples, despite antiviral and immunomodulator treatment. Clinical evolution in the blood was marked by an increase (2-3-fold) in differentiated effector T cells expressing exhaustion (PD-1) and senescence (CD57) markers, an expansion of antibody-secreting cells, a 15-fold increase in gammadelta T cell and proliferating NK-cell populations, and the total disappearance of monocytes, suggesting lung trafficking. In the serum, waves of a pro-inflammatory cytokine storm, Th1 and Th2 activation, and markers of T cell exhaustion, apoptosis, cell cytotoxicity, and endothelial activation were observed until the fatal outcome. This case underscores the need for well-designed studies to investigate complementary approaches to control viral replication, the source of the hyperinflammatory status, and immunomodulation to target the pathophysiological response. The investigation was conducted as part of an overall French clinical cohort assessing patients with COVID-19 and registered in clinicaltrials.gov under the following number: NCT04262921.