Innate immune deficiencies in patients with COVID-19

 Marine Peyneau, Vanessa Granger, Paul-Henri Wicky, Dounia Khelifi-Touhami, Jean-Francois Timsit, Francois-Xavier Lescure, Yazdan Yazdanpanah, Alexy Tran-Dihn, Philippe Montravers, Renato Monteiro, Sylvie Chollet-Martin, Margarita Hurtado-Nedelec,  

View ORCID ProfileLuc de Chaisemartin

doi: https://doi.org/10.1101/2021.03.29.21254560

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2021.03.29.21254560v1.full.pdf

Abstract

COVID-19 can cause acute respiratory distress syndrome (ARDS), leading to death in a significant number of individuals. Evidence of a strong role of the innate immune system is accumulating, but the precise cells and mechanism involved remain unclear. In this study, we investigated the links between circulating innate phagocyte phenotype and functions and severity in COVID-19 patients. Eighty-four consecutive patients were included, 44 of which were in intensive care units (ICU). We performed an in-depth phenotyping of neutrophil and monocyte subpopulations and measured soluble activation markers in plasma. Additionally, myeloid cell functions (phagocytosis, oxidative burst, and NETosis) were evaluated on fresh cells from patients. Resulting parameters were linked to disease severity and prognosis. Both ICU and non-ICU patients had circulating neutrophils and monocytes with an activated phenotype, as well as elevated concentrations of soluble activation markers (calprotectin, myeloperoxidase, neutrophil extracellular traps, MMP9, sCD14) in their plasma. ICU patients were characterized by increased CD10low CD13low immature neutrophils, LOX-1+ and CCR5+ immunosuppressive neutrophils, and HLA-DRlow CD14low downregulated monocytes. Markers of immature and immunosuppressive neutrophils were strongly associated with severity and poor outcome. Moreover, neutrophils and monocytes of ICU patients had impaired antimicrobial functions, which correlated with organ dysfunction, severe infections, and mortality. Our study reveals a marked dysregulation of innate immunity in COVID-19 patients, which was correlated with severity and prognosis. Together, our results strongly argue in favor of a pivotal role of innate immunity in COVID-19 severe infections and pleads for targeted therapeutic options.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work was funded by the French National Research Agency (ANR) RA-COVID-19 V5 grant under the name COVINNATE

https://www.medrxiv.org/content/10.1101/2021.03.29.21254560v1