Severe Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests
During the COVID-19 pandemic, a phenomenon emerged in which some patients with severe disease were critically ill and could not be discharged from the ICU even though they exhibited negative viral tests. To explore the underlying mechanism, we collected blood samples from these patients and analyzed...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:d0ce77bae62b41e8aabfc551391b91622021-11-19T06:40:12ZSevere Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests1664-322410.3389/fimmu.2021.755579https://doaj.org/article/d0ce77bae62b41e8aabfc551391b91622021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.755579/fullhttps://doaj.org/toc/1664-3224During the COVID-19 pandemic, a phenomenon emerged in which some patients with severe disease were critically ill and could not be discharged from the ICU even though they exhibited negative viral tests. To explore the underlying mechanism, we collected blood samples from these patients and analyzed the gene expression profiles of peripheral immune cells. We found that all enrolled patients, regardless of changes in genes related to different symptoms and inflammatory responses, showed universally and severely decreased expression of adaptive immunity-related genes, especially those related to T/B cell arms and HLA molecules, and that these patients exhibited long-term secondary infections. In addition, no significant change was found in the expression of classic immunosuppression molecules including PD-1, PD-L1, and CTLA-4, suggesting that the adaptive immune suppression may not be due to the change of these genes. According to the published literatures and our data, this adaptive immunosuppression is likely to be caused by the “dysregulated host response” to severe infection, similar to the immunosuppression that exists in other severely infected patients with sepsis.Yue ZhouXuelian LiaoXiangrong SongMin HeFei XiaoXiaodong JinXiaoqi XieZhongwei ZhangBo WangChenliang ZhouYan KangWei ZhangFrontiers Media S.A.articleCOVID-19adaptive immune suppressionsecondary infectionstranscriptome sequencingSARS-CoV-2Immunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021) |
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COVID-19 adaptive immune suppression secondary infections transcriptome sequencing SARS-CoV-2 Immunologic diseases. Allergy RC581-607 |
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COVID-19 adaptive immune suppression secondary infections transcriptome sequencing SARS-CoV-2 Immunologic diseases. Allergy RC581-607 Yue Zhou Xuelian Liao Xiangrong Song Min He Fei Xiao Xiaodong Jin Xiaoqi Xie Zhongwei Zhang Bo Wang Chenliang Zhou Yan Kang Wei Zhang Severe Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests |
| description |
During the COVID-19 pandemic, a phenomenon emerged in which some patients with severe disease were critically ill and could not be discharged from the ICU even though they exhibited negative viral tests. To explore the underlying mechanism, we collected blood samples from these patients and analyzed the gene expression profiles of peripheral immune cells. We found that all enrolled patients, regardless of changes in genes related to different symptoms and inflammatory responses, showed universally and severely decreased expression of adaptive immunity-related genes, especially those related to T/B cell arms and HLA molecules, and that these patients exhibited long-term secondary infections. In addition, no significant change was found in the expression of classic immunosuppression molecules including PD-1, PD-L1, and CTLA-4, suggesting that the adaptive immune suppression may not be due to the change of these genes. According to the published literatures and our data, this adaptive immunosuppression is likely to be caused by the “dysregulated host response” to severe infection, similar to the immunosuppression that exists in other severely infected patients with sepsis. |
| format |
article |
| author |
Yue Zhou Xuelian Liao Xiangrong Song Min He Fei Xiao Xiaodong Jin Xiaoqi Xie Zhongwei Zhang Bo Wang Chenliang Zhou Yan Kang Wei Zhang |
| author_facet |
Yue Zhou Xuelian Liao Xiangrong Song Min He Fei Xiao Xiaodong Jin Xiaoqi Xie Zhongwei Zhang Bo Wang Chenliang Zhou Yan Kang Wei Zhang |
| author_sort |
Yue Zhou |
| title |
Severe Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests |
| title_short |
Severe Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests |
| title_full |
Severe Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests |
| title_fullStr |
Severe Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests |
| title_full_unstemmed |
Severe Adaptive Immune Suppression May Be Why Patients With Severe COVID-19 Cannot Be Discharged From the ICU Even After Negative Viral Tests |
| title_sort |
severe adaptive immune suppression may be why patients with severe covid-19 cannot be discharged from the icu even after negative viral tests |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/d0ce77bae62b41e8aabfc551391b9162 |
| work_keys_str_mv |
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