Distinct systemic immune networks define severe vs. mild COVID-19 in hematologic and solid cancer patients
Year: 2023
Type: article
Study design: Observational Study
Abstract: Introduction: The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, has impacted health across all sectors of society. A cytokine-release syndrome, combined with an inefficient response of innate immune cells to directly combat the virus, characterizes the severe form of COVID-19. While immune factors involved in the development of severe COVID-19 in the general population are becoming clearer, identification of the immune mechanisms behind severe disease in oncologic patients remains uncertain. Methods: Here we evaluated the systemic immune response through the analysis of soluble blood immune factors and anti-SARS-CoV-2 antibodies within the early days of a positive SARS-CoV-2 diagnostic in oncologic patients. Results: Individuals with hematologic malignancies that went on to die from COVID-19 displayed at diagnosis severe leukopenia, low antibody production against SARS-CoV-2 proteins, and elevated production of innate immune cell recruitment and activation factors. These patients also displayed correlation networks in which IL-2, IL-13, TNF-alpha, IFN-gamma, and FGF2 were the focal points. Hematologic cancer patients that showed highly networked and coordinated anti-SARS-CoV-2 antibody production, with central importance of IL-4, IL-5, IL-12A, IL-15, and IL-17A, presented only mild COVID-19. Conversely, solid tumor patients that had elevated levels of inflammatory cytokines IL-6, CXCL8, and lost the coordinate production of anti-virus antibodies developed severe COVID-19 and died. Patients that displayed positive correlation networks between anti-virus antibodies, and a regulatory axis involving IL-10 and inflammatory cytokines recovered from the disease. We also provided evidence that CXCL8 is a strong predictor of death for oncologic patients and could be an indicator of poor prognosis within days of the positive diagnostic of SARS-CoV-2 infection. Conclusion: Our findings defined distinct systemic immune profiles associated with COVID-19 clinical outcome of patients with cancer and COVID-19. These systemic immune networks shed light on potential immune mechanisms involved in disease outcome, as well as identify potential clinically useful biomarkers.
Source: Frontiers in Immunology
Authors: Flávio Pignataro-Oshiro, Amanda B. Figueiredo, Nayane A. L. Galdino, Katia L. P. Morais, Walderez O. Dutra, Bianca Grassi de Miranda Silva, Diego Feriani, Flávia de Azevedo Abrantes, Ivan Leonardo Avelino França e Silva, Jayr Schmidt Filho, Juliana Valéria de Souza Framil, Marcelle Goldner Cesca, Rachel Simões Pimenta Riechelmann, Marjorie V. Batista, Kenneth J. Gollob
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,295
Awards: Risk factors associated with an immune response, microbiome / viroma and metabolomics in determining outcome of infection by the new Coronavirus (SARS-CoV-2) in cancer patients, The interplay of the immune system, and microbiome in determining outcome of respiratory viral infections in hematopoietic cell transplant recipients and in patients with leukemia
OpenAlex ID: W4313890337