Abstract
BackgroundEmerging evidence indicates a potential role for monocytes in COVID-19 immunopathology. We investigated two soluble markers of monocyte activation, sCD14 and sCD163, in COVID-19 patients, with the aim of characterizing their potential role in monocyte-macrophage disease immunopathology. To the best of our knowledge, this is the first study of its kind.MethodsFifty-nine SARS-Cov-2 positive hospitalized patients, classified according to ICU or non-ICU admission requirement, were prospectively recruited and analyzed by ELISA for levels of sCD14 and sCD163, along with other laboratory parameters, and compared to a healthy control group.ResultssCD14 and sCD163 levels were significantly higher among COVID-19 patients, independently of ICU admission requirement, compared to the control group. We found a significant correlation between sCD14 levels and other inflammatory markers, particularly Interleukin-6, in the non-ICU patients group. sCD163 showed a moderate positive correlation with the time lapsed from admission to sampling, independently of severity group. Treatment with corticoids showed an interference with sCD14 levels, whereas hydroxychloroquine and tocilizumab did not.ConclusionsMonocyte-macrophage activation markers are increased and correlate with other inflammatory markers in SARS-Cov-2 infection, in association to hospital admission. These data suggest a preponderant role for monocyte-macrophage activation in the development of immunopathology of COVID-19 patients.
Highlights
Emerging evidence from SARS-Cov-2 infected patients suggests a key role for monocyte-macrophage in the immunopathology of COVID-19 infection, with a predominant monocytederived macrophage infiltration observed in severely damaged lungs [1], and morphological and inflammation-related changes in peripheral blood monocytes that correlate with the patients’ outcome [2]
CD14 and CD163 are both myeloid differentiation markers found primarily on monocytes and macrophages, and detection of soluble release of both in plasma is considered a good biomarker of monocyte-macrophage activation [11, 12]
A leading cause of death associated with increased susceptibility to secondary infections and immunosuppression, soluble CD14 (sCD14) and soluble CD163 (sCD163) levels have been found to be significantly higher, indicating an important and persistent monocyte-macrophage activation [17]
Summary
Emerging evidence from SARS-Cov-2 infected patients suggests a key role for monocyte-macrophage in the immunopathology of COVID-19 infection, with a predominant monocytederived macrophage infiltration observed in severely damaged lungs [1], and morphological and inflammation-related changes in peripheral blood monocytes that correlate with the patients’ outcome [2]. An overexuberant inflammatory immune response with production of a cytokine storm and T-cell immunosuppression are the main hallmarks of severity in these patients [3] This clinical course resembles viral-associated hemophagocytic syndrome (VAHS), a rare severe complication of various viral infections mediated by proinflammatory cytokines, resulting in multiorgan failure and death [4]. A leading cause of death associated with increased susceptibility to secondary infections and immunosuppression, sCD14 and sCD163 levels have been found to be significantly higher, indicating an important and persistent monocyte-macrophage activation [17]. We investigated two soluble markers of monocyte activation, sCD14 and sCD163, in COVID-19 patients, with the aim of characterizing their potential role in monocyte-macrophage disease immunopathology. To the best of our knowledge, this is the first study of its kind
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