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10.1016/j.chest.2020.11.049 http://scihub22266oqcxt.onion/10.1016/j.chest.2020.11.049 33316234!7831685!33316234     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Chest 2021 ; 159 (5): 1884-1893 Nephropedia Template TP {{tp|p=33316234|t=2021. Identification of Distinct Immunophenotypes in Critically Ill Coronavirus Disease 2019 Patients |pdf=|usr=}}{{33316234}} gab.com Text Identification of Distinct Immunophenotypes in Critically Ill Coronavirus Disease 2019 Patients JO: Chest http://www.kidney.de/pget.php?&tw=1&pmid=33316234 #FOAvip BACKGROUND: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection causes direct lung damage, overwhelming endothelial activation, and inflammatory reaction, leading to acute respiratory failure and multi-organ dysfunction. Ongoing clinical trials are evaluating targeted therapies to hinder this exaggerated inflammatory response. Critically ill coronavirus disease 2019 (COVID-19) patients have shown heterogeneous severity trajectories, suggesting that response to therapies is likely to vary across patients. RESEARCH QUESTION: Are critically ill COVID-19 patients biologically and immunologically dissociable based on profiling of currently evaluated therapeutic targets? STUDY DESIGN AND METHODS: We did a single-center, prospective study in an ICU department in France. Ninety-six critically ill adult patients admitted with a documented SARS-CoV-2 infection were enrolled. We conducted principal components analysis and hierarchical clustering on a vast array of immunologic variables measured on the day of ICU admission. RESULTS: We found that patients were distributed in three clusters bearing distinct immunologic features and associated with different ICU outcomes. Cluster 1 had a "humoral immunodeficiency" phenotype with predominant B-lymphocyte defect, relative hypogammaglobulinemia, and moderate inflammation. Cluster 2 had a "hyperinflammatory" phenotype, with high cytokine levels (IL-6, IL-1beta, IL-8, tumor necrosis factor-alpha [TNF?]) associated with CD4+ and CD8+ T-lymphocyte defects. Cluster 3 had a "complement-dependent" phenotype with terminal complement activation markers (elevated C3 and sC5b-9). INTERPRETATION: Patients with severe COVID-19 exhibiting cytokine release marks, complement activation, or B-lymphocyte defects are distinct from each other. Such immunologic variability argues in favor of targeting different mediators in different groups of patients and could serve as a basis for patient identification and clinical trial eligibility. Twit Text FOAVip Identification of Distinct Immunophenotypes in Critically Ill Coronavirus Disease 2019 Patients ????Chest http://www.kidney.de/pget.php?&tw=1&pmid=33316234 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=33316234 #FOAvip English Wikipedia <ref>{{Cite pmid|33316234}}</ref> Identification of Distinct Immunophenotypes in Critically Ill Coronavirus Disease 2019 Patients #MMPMID33316234 Dupont T; Caillat-Zucman S; Fremeaux-Bacchi V; Morin F; Lengline E; Darmon M; Peffault de Latour R; Zafrani L; Azoulay E; Dumas G Chest 2021[May]; 159 (5): 1884-1893 PMID33316234show ga BACKGROUND: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection causes direct lung damage, overwhelming endothelial activation, and inflammatory reaction, leading to acute respiratory failure and multi-organ dysfunction. Ongoing clinical trials are evaluating targeted therapies to hinder this exaggerated inflammatory response. Critically ill coronavirus disease 2019 (COVID-19) patients have shown heterogeneous severity trajectories, suggesting that response to therapies is likely to vary across patients. RESEARCH QUESTION: Are critically ill COVID-19 patients biologically and immunologically dissociable based on profiling of currently evaluated therapeutic targets? STUDY DESIGN AND METHODS: We did a single-center, prospective study in an ICU department in France. Ninety-six critically ill adult patients admitted with a documented SARS-CoV-2 infection were enrolled. We conducted principal components analysis and hierarchical clustering on a vast array of immunologic variables measured on the day of ICU admission. RESULTS: We found that patients were distributed in three clusters bearing distinct immunologic features and associated with different ICU outcomes. Cluster 1 had a "humoral immunodeficiency" phenotype with predominant B-lymphocyte defect, relative hypogammaglobulinemia, and moderate inflammation. Cluster 2 had a "hyperinflammatory" phenotype, with high cytokine levels (IL-6, IL-1beta, IL-8, tumor necrosis factor-alpha [TNF?]) associated with CD4+ and CD8+ T-lymphocyte defects. Cluster 3 had a "complement-dependent" phenotype with terminal complement activation markers (elevated C3 and sC5b-9). INTERPRETATION: Patients with severe COVID-19 exhibiting cytokine release marks, complement activation, or B-lymphocyte defects are distinct from each other. Such immunologic variability argues in favor of targeting different mediators in different groups of patients and could serve as a basis for patient identification and clinical trial eligibility. |*COVID-19/epidemiology/immunology/therapy[MESH] |B-Lymphocytes/immunology[MESH] |Biomarkers/*blood[MESH] |Cluster Analysis[MESH] |Common Variable Immunodeficiency/*immunology[MESH] |Complement Activation/*immunology[MESH] |Critical Illness/epidemiology/therapy[MESH] |Cytokine Release Syndrome/diagnosis/immunology[MESH] |Female[MESH] |France/epidemiology[MESH] |Humans[MESH] |Inflammation/*immunology[MESH] |Intensive Care Units/statistics & numerical data[MESH] |Male[MESH] |Middle Aged[MESH] |Prospective Studies[MESH]Identification of Distinct Immunophenotypes in Critically Ill Coronavi(epmc).pdf DeepDyve Pubget Overpricing