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10.1164/rccm.202005-1885OC

http://scihub22266oqcxt.onion/10.1164/rccm.202005-1885OC
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32866033!7706149!32866033
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suck abstract from ncbi


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pmid32866033      Am+J+Respir+Crit+Care+Med 2020 ; 202 (11): 1509-1519
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  • Uncontrolled Innate and Impaired Adaptive Immune Responses in Patients with COVID-19 Acute Respiratory Distress Syndrome #MMPMID32866033
  • Hue S; Beldi-Ferchiou A; Bendib I; Surenaud M; Fourati S; Frapard T; Rivoal S; Razazi K; Carteaux G; Delfau-Larue MH; Mekontso-Dessap A; Audureau E; de Prost N
  • Am J Respir Crit Care Med 2020[Dec]; 202 (11): 1509-1519 PMID32866033show ga
  • Rationale: Uncontrolled inflammatory innate response and impaired adaptive immune response are associated with clinical severity in patients with coronavirus disease (COVID-19).Objectives: To compare the immunopathology of COVID-19 acute respiratory distress syndrome (ARDS) with that of non-COVID-19 ARDS, and to identify biomarkers associated with mortality in patients with COVID-19 ARDS.Methods: Prospective observational monocenter study. Immunocompetent patients diagnosed with RT-PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and ARDS admitted between March 8 and March 30, 2020, were included and compared with patients with non-COVID-19 ARDS. The primary clinical endpoint of the study was mortality at Day 28. Flow cytometry analyses and serum cytokine measurements were performed at Days 1-2 and 4-6 of ICU admission.Measurements and Main Results: As compared with patients with non-COVID-19 ARDS (n = 36), those with COVID-19 (n = 38) were not significantly different regarding age, sex, and Sequential Organ Failure Assessment and Simplified Acute Physiology Score II scores but exhibited a higher Day-28 mortality (34% vs. 11%, P = 0.030). Patients with COVID-19 showed profound and sustained T CD4(+) (P = 0.002), CD8(+) (P < 0.0001), and B (P < 0.0001) lymphopenia, higher HLA-DR expression on monocytes (P < 0.001) and higher serum concentrations of EGF (epithelial growth factor), GM-CSF, IL-10, CCL2/MCP-1, CCL3/MIP-1a, CXCL10/IP-10, CCL5/RANTES, and CCL20/MIP-3a. After adjusting on age and Sequential Organ Failure Assessment, serum CXCL10/IP-10 (P = 0.047) and GM-CSF (P = 0.050) were higher and nasopharyngeal RT-PCR cycle threshold values lower (P = 0.010) in patients with COVID-19 who were dead at Day 28.Conclusions: Profound global lymphopenia and a "chemokine signature" were observed in COVID-19 ARDS. Increased serum concentrations of CXCL10/IP-10 and GM-CSF, together with higher nasopharyngeal SARS-CoV-2 viral load, were associated with Day-28 mortality.
  • |*Immunity, Innate[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Antibodies, Viral/*blood[MESH]
  • |COVID-19/blood/epidemiology/*immunology/*physiopathology[MESH]
  • |Chemokines/*blood[MESH]
  • |Female[MESH]
  • |France/epidemiology[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Prospective Studies[MESH]
  • |Respiratory Distress Syndrome/blood/epidemiology/*immunology/*physiopathology[MESH]


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