tetano
Editor, Senior Moderator
Nat Commun
. 2020 Oct 8;11(1):5086.
doi: 10.1038/s41467-020-18854-2.
Two distinct immunopathological profiles in autopsy lungs of COVID-19
Ronny Nienhold[SUP] 1 [/SUP], Yari Ciani[SUP] 2 [/SUP], Viktor H Koelzer[SUP] 3 4 [/SUP], Alexandar Tzankov[SUP] 5 [/SUP], Jasmin D Haslbauer[SUP] 5 [/SUP], Thomas Menter[SUP] 5 [/SUP], Nathalie Schwab[SUP] 1 [/SUP], Maurice Henkel[SUP] 1 [/SUP], Angela Frank[SUP] 1 [/SUP], Veronika Zsikla[SUP] 1 [/SUP], Niels Willi[SUP] 1 [/SUP], Werner Kempf[SUP] 6 [/SUP], Thomas Hoyler[SUP] 7 [/SUP], Mattia Barbareschi[SUP] 8 [/SUP], Holger Moch[SUP] 3 [/SUP], Markus Tolnay[SUP] 5 [/SUP], Gieri Cathomas[SUP] 1 [/SUP], Francesca Demichelis[SUP] 2 9 [/SUP], Tobias Junt[SUP] 7 [/SUP], Kirsten D Mertz[SUP] 10 [/SUP]
Affiliations
Abstract
Coronavirus Disease 19 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has grown to a worldwide pandemic with substantial mortality. Immune mediated damage has been proposed as a pathogenic factor, but immune responses in lungs of COVID-19 patients remain poorly characterized. Here we show transcriptomic, histologic and cellular profiles of post mortem COVID-19 (n = 34 tissues from 16 patients) and normal lung tissues (n = 9 tissues from 6 patients). Two distinct immunopathological reaction patterns of lethal COVID-19 are identified. One pattern shows high local expression of interferon stimulated genes (ISG[SUP]high[/SUP]) and cytokines, high viral loads and limited pulmonary damage, the other pattern shows severely damaged lungs, low ISGs (ISG[SUP]low[/SUP]), low viral loads and abundant infiltrating activated CD8[SUP]+[/SUP] T cells and macrophages. ISG[SUP]high[/SUP] patients die significantly earlier after hospitalization than ISG[SUP]low[/SUP] patients. Our study may point to distinct stages of progression of COVID-19 lung disease and highlights the need for peripheral blood biomarkers that inform about patient lung status and guide treatment.
. 2020 Oct 8;11(1):5086.
doi: 10.1038/s41467-020-18854-2.
Two distinct immunopathological profiles in autopsy lungs of COVID-19
Ronny Nienhold[SUP] 1 [/SUP], Yari Ciani[SUP] 2 [/SUP], Viktor H Koelzer[SUP] 3 4 [/SUP], Alexandar Tzankov[SUP] 5 [/SUP], Jasmin D Haslbauer[SUP] 5 [/SUP], Thomas Menter[SUP] 5 [/SUP], Nathalie Schwab[SUP] 1 [/SUP], Maurice Henkel[SUP] 1 [/SUP], Angela Frank[SUP] 1 [/SUP], Veronika Zsikla[SUP] 1 [/SUP], Niels Willi[SUP] 1 [/SUP], Werner Kempf[SUP] 6 [/SUP], Thomas Hoyler[SUP] 7 [/SUP], Mattia Barbareschi[SUP] 8 [/SUP], Holger Moch[SUP] 3 [/SUP], Markus Tolnay[SUP] 5 [/SUP], Gieri Cathomas[SUP] 1 [/SUP], Francesca Demichelis[SUP] 2 9 [/SUP], Tobias Junt[SUP] 7 [/SUP], Kirsten D Mertz[SUP] 10 [/SUP]
Affiliations
- PMID: 33033248
- DOI: 10.1038/s41467-020-18854-2
Abstract
Coronavirus Disease 19 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has grown to a worldwide pandemic with substantial mortality. Immune mediated damage has been proposed as a pathogenic factor, but immune responses in lungs of COVID-19 patients remain poorly characterized. Here we show transcriptomic, histologic and cellular profiles of post mortem COVID-19 (n = 34 tissues from 16 patients) and normal lung tissues (n = 9 tissues from 6 patients). Two distinct immunopathological reaction patterns of lethal COVID-19 are identified. One pattern shows high local expression of interferon stimulated genes (ISG[SUP]high[/SUP]) and cytokines, high viral loads and limited pulmonary damage, the other pattern shows severely damaged lungs, low ISGs (ISG[SUP]low[/SUP]), low viral loads and abundant infiltrating activated CD8[SUP]+[/SUP] T cells and macrophages. ISG[SUP]high[/SUP] patients die significantly earlier after hospitalization than ISG[SUP]low[/SUP] patients. Our study may point to distinct stages of progression of COVID-19 lung disease and highlights the need for peripheral blood biomarkers that inform about patient lung status and guide treatment.