TY - JOUR
T1 - Characteristic Immune Dynamics in COVID-19 Patients with Cardiac Dysfunction
AU - Gonzalez, Filipe André
AU - Ângelo-Dias, Miguel
AU - Martins, Catarina
AU - Gomes, Rui
AU - Bacariza, Jacobo
AU - Fernandes, Antero
AU - Borrego, Luís Miguel
N1 - Funding Information:
Type of funding sources: Foundation—015_595935779—Foundation for Science and Technology (FCT), in collaboration with the Agency for Clinical Research and Biomedical Innovation (AICIB) opened special funding, “RESEARCH 4 COVID-19”, to R&D projects and initiatives that respond to the needs of the National Health Service (SNS) as a response to this and future pandemics in a very short time Horizon. Project: “Early recognition of cardiac injury associated with COVID-19 and clinical outcomes”.
PY - 2022/3/28
Y1 - 2022/3/28
N2 - Background: We aimed to explore immune parameters in COVID-19 patients admitted to the intensive care unit (ICU) to identify distinctive features in patients with cardiac injury. Methods: A total of 30 COVID-19 patients >18 years admitted to the ICU were studied on days D1, D3 and D7 after admission. Cardiac function was assessed using speckle-tracking echocardiography (STE). Peripheral blood immunophenotyping, cardiac (pro-BNP; troponin) and inflammatory biomarkers were simultaneously evaluated. Results: Cardiac dysfunction (DYS) was detected by STE in 73% of patients: 40% left ventricle (LV) systolic dysfunction, 60% LV diastolic dysfunction, 37% right ventricle systolic dysfunction. High-sensitivity cardiac troponin (hs-cTn) was detectable in 43.3% of the patients with a median value of 13.00 ng/L. There were no significant differences between DYS and nDYS patients regarding mortality, organ dysfunction, cardiac (including hs-cTn) or inflammatory biomarkers. Patients with DYS showed persistently lower lymphocyte counts (median 896 [661–1837] cells/µL vs. 2141 [924–3306] cells/µL, p = 0.058), activated CD3 (median 85 [66–170] cells/µL vs. 186 [142–259] cells/µL, p = 0.047) and CD4 T cells (median 33 [28–40] cells/µL vs. 63 [48–79] cells/µL, p = 0.005), and higher effector memory T cells (TEM) at baseline (CD4%: 10.9 [6.4–19.2] vs. 5.9 [4.2–12.8], p = 0.025; CD8%: 15.7 [7.9–22.8] vs. 8.1 [7.7–13.7], p = 0.035; CD8 counts: 40 cells/µL [17–61] vs. 10 cells/µL [7–17], p = 0.011) than patients without cardiac dysfunction. Conclusion: Our study suggests an association between the immunological trait and cardiac dysfunction in severe COVID-19 patients.
AB - Background: We aimed to explore immune parameters in COVID-19 patients admitted to the intensive care unit (ICU) to identify distinctive features in patients with cardiac injury. Methods: A total of 30 COVID-19 patients >18 years admitted to the ICU were studied on days D1, D3 and D7 after admission. Cardiac function was assessed using speckle-tracking echocardiography (STE). Peripheral blood immunophenotyping, cardiac (pro-BNP; troponin) and inflammatory biomarkers were simultaneously evaluated. Results: Cardiac dysfunction (DYS) was detected by STE in 73% of patients: 40% left ventricle (LV) systolic dysfunction, 60% LV diastolic dysfunction, 37% right ventricle systolic dysfunction. High-sensitivity cardiac troponin (hs-cTn) was detectable in 43.3% of the patients with a median value of 13.00 ng/L. There were no significant differences between DYS and nDYS patients regarding mortality, organ dysfunction, cardiac (including hs-cTn) or inflammatory biomarkers. Patients with DYS showed persistently lower lymphocyte counts (median 896 [661–1837] cells/µL vs. 2141 [924–3306] cells/µL, p = 0.058), activated CD3 (median 85 [66–170] cells/µL vs. 186 [142–259] cells/µL, p = 0.047) and CD4 T cells (median 33 [28–40] cells/µL vs. 63 [48–79] cells/µL, p = 0.005), and higher effector memory T cells (TEM) at baseline (CD4%: 10.9 [6.4–19.2] vs. 5.9 [4.2–12.8], p = 0.025; CD8%: 15.7 [7.9–22.8] vs. 8.1 [7.7–13.7], p = 0.035; CD8 counts: 40 cells/µL [17–61] vs. 10 cells/µL [7–17], p = 0.011) than patients without cardiac dysfunction. Conclusion: Our study suggests an association between the immunological trait and cardiac dysfunction in severe COVID-19 patients.
KW - COVID-19
KW - diastolic dysfunction
KW - flow cytometry
KW - speckle-tracking echocardiography
UR - http://www.scopus.com/inward/record.url?scp=85127028056&partnerID=8YFLogxK
U2 - 10.3390/jcm11071880
DO - 10.3390/jcm11071880
M3 - Article
C2 - 35407485
AN - SCOPUS:85127028056
SN - 2077-0383
VL - 11
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 7
M1 - 1880
ER -