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Differential association between inflammatory cytokines and multiorgan dysfunction in COVID-19 patients with obesity.

ABSTRACT: To investigate the mechanisms underlying the SARS-CoV-2 infection severity observed in patients with obesity, we performed a prospective study of 51 patients evaluating the impact of multiple immune parameters during 2 weeks after admission, on vital organs' functions according to body mass index (BMI) categories. High-dimensional flow cytometric characterization of immune cell subsets was performed at admission, 30 systemic cytokines/chemokines levels were sequentially measured, thirteen endothelial markers were determined at admission and at the zenith of the cytokines. Computed tomography scans on admission were quantified for lung damage and hepatic steatosis (n = 23). Abnormal BMI (> 25) observed in 72.6% of patients, was associated with a higher rate of intensive care unit hospitalization (p = 0.044). SARS-CoV-2 RNAaemia, peripheral immune cell subsets and cytokines/chemokines were similar among BMI groups. A significant association between inflammatory cytokines and liver, renal, and endothelial dysfunctions was observed only in patients with obesity (BMI > 30). In contrast, early signs of lung damage (ground-glass opacity) correlated with Th1/M1/inflammatory cytokines only in normal weight patients. Later lesions of pulmonary consolidation correlated with BMI but were independent of cytokine levels. Our study reveals distinct physiopathological mechanisms associated with SARS-CoV-2 infection in patients with obesity that may have important clinical implications.

SUBMITTER: Dragon-Durey MA

PROVIDER: S-EPMC8153504 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Differential association between inflammatory cytokines and multiorgan dysfunction in COVID-19 patients with obesity.

Dragon-Durey Marie-Agnès MA Chen Xiaoyi X Kirilovsky Amos A Ben Hamouda Nadine N El Sissy Carine C Russick Jules J Charpentier Etienne E Binois Yannick Y Marliot Florence F Meylan Maxime M Granier Clémence C Pere Hélène H Saldmann Antonin A Rance Bastien B Jannot Anne Sophie AS Baron Stéphanie S Chebbi Mouna M Fayol Antoine A Josseaume Nathalie N Rives-Lange Claire C Tharaux Pierre-Louis PL Cholley Bernard B Diehl Jean-Luc JL Arlet Jean-Benoît JB Azizi Michel M Karras Alexandre A Czernichow Sébastien S Smadja David M DM Hulot Jean-Sébastien JS Cremer Isabelle I Tartour Eric E Mousseaux Elie E Pagès Franck F

PloS one 20210526 5

To investigate the mechanisms underlying the SARS-CoV-2 infection severity observed in patients with obesity, we performed a prospective study of 51 patients evaluating the impact of multiple immune parameters during 2 weeks after admission, on vital organs' functions according to body mass index (BMI) categories. High-dimensional flow cytometric characterization of immune cell subsets was performed at admission, 30 systemic cytokines/chemokines levels were sequentially measured, thirteen endoth ...[more]

PMID: 34038475

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Project description:BackgroundCharacterizing the multiorgan manifestations and outcomes of patients hospitalized with COVID-19 will inform resource requirements to address the long-term burden of this disease. We conducted a descriptive analysis using prospectively collected data to describe the clinical characteristics and spectrum of organ dysfunction, and in-hospital and longer-term clinical outcomes of patients hospitalized with COVID-19 during the first wave of the pandemic at a Canadian centre.MethodsWe conducted a prospective case series involving adult patients (aged ≥ 18 yr) with COVID-19 admitted to 1 of 2 hospitals in London, Ontario, from Mar. 17 to June 18, 2020, during the first wave of the pandemic. We recorded patients' baseline characteristics, physiologic parameters, measures of organ function and therapies administered during hospitalization among patients in the intensive care unit (ICU) and in non-ICU settings, and compared the characteristics of hospital survivors and nonsurvivors. Finally, we recorded follow-up thoracic computed tomography (CT) and echocardiographic findings after hospital discharge.ResultsWe enrolled 100 consecutive patients (47 women) hospitalized with COVID-19, including 32 patients who received ICU care and 68 who received treatment in non-ICU settings. Respiratory sequelae were common: 23.0% received high-flow oxygen by nasal cannula, 9.0% received noninvasive ventilation, 24.0% received invasive mechanical ventilation and 2.0% received venovenous extracorporeal membrane oxygenation. Overall, 9.0% of patients had cerebrovascular events (3.0% ischemic stroke, 6.0% intracranial hemorrhage), and 6.0% had pulmonary embolism. After discharge, 11 of 19 patients had persistent abnormalities on CT thorax, and 6 of 15 had persistent cardiac dysfunction on echocardiography.InterpretationThis study provides further evidence that COVID-19 is a multisystem disease involving neurologic, cardiac and thrombotic dysfunction, without evidence of hepatic dysfunction. Patients have persistent organ dysfunction after hospital discharge, underscoring the need for research on long-term outcomes of COVID-19 survivors.

Dataset Information

Differential association between inflammatory cytokines and multiorgan dysfunction in COVID-19 patients with obesity.

Publications

Differential association between inflammatory cytokines and multiorgan dysfunction in COVID-19 patients with obesity.

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