Preprint Article Version 1 This version is not peer-reviewed

Complex Immuno-metabolic Profiling Reveals Activation of Cellular Immunity and Biliary Lesion in Patients with Severe COVID-19

Version 1 : Received: 22 July 2020 / Approved: 24 July 2020 / Online: 24 July 2020 (14:40:42 CEST)

How to cite: Klocperk, A.; Bloomfield, M.; Parackova, Z.; Zentsova, I.; Vrabcova, P.; Balko, J.; Meseznikov, G.; Casas Mendez, L.F.; Grandcourtova, A.; Sipek, J.; Tulach, M.; Zamecnik, J.; Vymazal, T.; Sediva, A. Complex Immuno-metabolic Profiling Reveals Activation of Cellular Immunity and Biliary Lesion in Patients with Severe COVID-19. Preprints 2020, 2020070596 (doi: 10.20944/preprints202007.0596.v1). Klocperk, A.; Bloomfield, M.; Parackova, Z.; Zentsova, I.; Vrabcova, P.; Balko, J.; Meseznikov, G.; Casas Mendez, L.F.; Grandcourtova, A.; Sipek, J.; Tulach, M.; Zamecnik, J.; Vymazal, T.; Sediva, A. Complex Immuno-metabolic Profiling Reveals Activation of Cellular Immunity and Biliary Lesion in Patients with Severe COVID-19. Preprints 2020, 2020070596 (doi: 10.20944/preprints202007.0596.v1).

Abstract

The aim of this study was to assess the key laboratory features displayed by coronavirus disease 2019 (COVID-19) inpatients which associated with mild, moderate, severe and fatal course of the disease and, through longitudinal follow-up, to understand the dynamics of COVID-19 pathophysiology. All SARS-CoV-2 positive patients admitted to the University Hospital in Motol between March and June 2020 were included in this study. Severe course of COVID-19 was associated with elevation of proinflammatory markers, efflux of immature granulocytes into peripheral blood, activation of CD8 T cells, which infiltrate lungs, and transient liver disease. In particular, the elevation of serum gamma-glutamyl transferase (GGT) and histological signs of cholestasis were highly specific for patients with severe disease. In contrast, patients with fatal course of COVID-19 failed to upregulate markers of inflammation, showed dyscoordination of immune response and progressed towards acute kidney failure. COVID-19 is a disease with multi-organ affinity characterized by activation of innate and cellular adaptive immunity. Biliary lesion with elevation of GGT and organ-infiltration of IL-6 producing cells are defining characteristic for patients with fulminant disease.

Subject Areas

COVID-19; SARS-CoV-2; immunity; T cells; IL-6; GGT; hepatopathy; biliary lesion; acute kidney injury; liver disease

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