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_high) and cytokines, high viral loads and limited pulmonary damage, the other pattern shows severely damaged lungs, low ISGs (ISG_low), low viral loads and abundant infiltrating activated CD8+ T cells and macrophages. ISG_high patients die significantly earlier after hospitalization than ISG_low 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.
Two distinct immunopathological profiles in autopsy lungs of COVID-19 / Nienhold, R; Ciani, Y; Koelzer, V; Tzankov, A; Haslbauer, J; Menter, T; Schwab, N; Henkel, M; Frank, A; Zsikla, V; Willi, N; Kempf, W; Hoyler, T; Barbareschi, M; Moch, H; Tolnay, M; Cathomas, G; Demichelis, Francesca; Mertz Kirsten, D.. - In: NATURE COMMUNICATIONS. - ISSN 2041-1723. - 2020:11(2020). [10.1038/s41467-020-18854-2]
Two distinct immunopathological profiles in autopsy lungs of COVID-19
Ciani Y;Barbareschi M;Demichelis Francesca;
2020-01-01
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_high) and cytokines, high viral loads and limited pulmonary damage, the other pattern shows severely damaged lungs, low ISGs (ISG_low), low viral loads and abundant infiltrating activated CD8+ T cells and macrophages. ISG_high patients die significantly earlier after hospitalization than ISG_low 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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione