Bhargava, A.; Knapp, J.D. Immunological Misfiring and Sex Differences/Similarities in Early COVID-19 Studies: Missed Opportunities of Making a Real IMPACT. Cells 2023, 12, 2591, doi:10.3390/cells12222591.
Bhargava, A.; Knapp, J.D. Immunological Misfiring and Sex Differences/Similarities in Early COVID-19 Studies: Missed Opportunities of Making a Real IMPACT. Cells 2023, 12, 2591, doi:10.3390/cells12222591.
Bhargava, A.; Knapp, J.D. Immunological Misfiring and Sex Differences/Similarities in Early COVID-19 Studies: Missed Opportunities of Making a Real IMPACT. Cells 2023, 12, 2591, doi:10.3390/cells12222591.
Bhargava, A.; Knapp, J.D. Immunological Misfiring and Sex Differences/Similarities in Early COVID-19 Studies: Missed Opportunities of Making a Real IMPACT. Cells 2023, 12, 2591, doi:10.3390/cells12222591.
Abstract
COVID-19-associated coagulopathy (CAC) and ICU admissions were recognized as critical health issues that contributed to the morbidity and mortality in SARS-CoV-2-infected patients. Here, we analyzed publicly available data from the Yale IMPACT cohort to address immunological misfiring and sex differences in early COVID-19 ICU patients by taking various biological variables into account that were not considered. In 2020, SARS-CoV-2 was considered far more pathogenic and lethal than other circulating respiratory viruses, and it is thus surprising that published studies failed to confirm whether all patients were indeed SARS-CoV-2+ at least by one method, thereby confounding many findings/conclusions. Several key findings were further missed or misinterpreted due to lack of consideration of several important biological variables such as days from symptoms onset (DFSO), risk factors, including obesity, and treatments that influence the immunological measures evaluated. The immune profile in the early phase of infection will differ vastly from mid-to-late phases of infection, which likely coincides with recovery or is the tipping point for progression to severe illness, and thus grouping patients from different phases/DFSO into one single group is not the right approach. Taken together, our analysis shows that interferon responses were dampened and none of the early treatments were effective in reducing levels of IL6, and that obese patients exhibited highest mortality and worst clinical scores. The opportunity to understand the contribution of biological sex, risk factors, and early treatments with respect to COVID-19-related ICU admission and progression to morbidity and mortality was missed.
Keywords
coagulopathy; COVID-19; CXCL; dendritic cells; ICU; IL6; IL7; IFN; sex differences and similarities
Subject
Medicine and Pharmacology, Immunology and Allergy
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
