Viral load at hospitalization is an independent predictor of severe <scp>COVID</scp>‐19

Waller, Hjalmar; Carmona-Vicente, Noelia; James, Axel; Govender, Melissa; Hopkins, Francis R.; Larsson, Marie; Hagbom, Marie; Svensson, Lennart; Enocsson, Helena; Gustafsson, Annette; Nilsdotter-Augustinsson, Åsa; Sjöwall, Johanna; Nordgren, Johan

doi:10.1111/eci.13882

Cited by 5 publications

(6 citation statements)

References 41 publications

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“…In addition, the COVID-19 patients with high CRP levels had lower levels of anti-spike IgG and neutralizing antibodies at inclusion. We have previously shown that viral load correlates to disease severity ( 87 ), that is in turn connected to suboptimal development of germinal centers ( 88 ) that in turn might be the reason for the delayed IgG response. However, our correlations do not definitely mean causality and so their underlying mechanisms warrant further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Since coronavirus disease 2019 (COVID- 19) was declared a pandemic on March 11, 2020, great progress has been made in combating the disease. To date, more than ten vaccines have been developed and granted emergency use listing by the World Health Organization (1).…”

Section: Introductionmentioning

confidence: 99%

“…The DC serve as a bridge between the innate and adaptive responses and are essential for the development of an adaptive response (19). Like monocytes, DC can be classified into different subsets with the ability to sense pathogens, produce cytokines and activate T cell responses (20).…”

Section: Introductionmentioning

confidence: 99%

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Major alterations to monocyte and dendritic cell subsets lasting more than 6 months after hospitalization for COVID-19

et al. 2023

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IntroductionAfter more than two years the Coronavirus disease-19 (COVID-19) pandemic continues to burden healthcare systems and economies worldwide, and it is evident that the effects on the immune system can persist for months post-infection. The activity of myeloid cells such as monocytes and dendritic cells (DC) is essential for correct mobilization of the innate and adaptive responses to a pathogen. Impaired levels and responses of monocytes and DC to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is likely to be a driving force behind the immune dysregulation that characterizes severe COVID-19.MethodsHere, we followed a cohort of COVID-19 patients hospitalized during the early waves of the pandemic for 6-7 months. The levels and phenotypes of circulating monocyte and DC subsets were assessed to determine both the early and long-term effects of the SARS-CoV-2 infection.ResultsWe found increased monocyte levels that persisted for 6-7 months, mostly attributed to elevated levels of classical monocytes. Myeloid derived suppressor cells were also elevated over this period. While most DC subsets recovered from an initial decrease, we found elevated levels of cDC2/cDC3 at the 6-7 month timepoint. Analysis of functional markers on monocytes and DC revealed sustained reduction in program death ligand 1 (PD-L1) expression but increased CD86 expression across almost all cell types examined. Finally, C-reactive protein (CRP) correlated positively to the levels of intermediate monocytes and negatively to the recovery of DC subsets.ConclusionBy exploring the myeloid compartments, we show here that alterations in the immune landscape remain more than 6 months after severe COVID-19, which could be indicative of ongoing healing and/or persistence of viral antigens.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Major alterations to monocyte and dendritic cell subsets lasting more than 6 months after hospitalization for COVID-19

et al. 2023

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“…The median age in the control group was 45 years old. The cohort is well characterized ( 6 , 25 , 27 , 28 ) and reflects characteristics and co-morbidities commonly seen in hospitalized patients with COVID-19.…”

Section: Resultsmentioning

confidence: 99%

“…We also found a long-term elevation of circulating pCRP following the resolution of the infection and healing of the airways. We have previously shown that immune cells such as T cells, dendritic cells and monocyte subsets are affected up to 6 months after COVID-19, with an ongoing low level of inflammation, probably due to tissue damage and repair of the airways ( 27 , 28 ). The elevated levels of pCRP may be a part in this ongoing inflammation, and further research should elucidate more of the mechanisms behind this.…”

Section: Discussionmentioning

confidence: 99%

Pentameric C-reactive protein is a better prognostic biomarker and remains elevated for longer than monomeric CRP in hospitalized patients with COVID-19

Hopkins,

Nordgren,

Fernandez-Botran

et al. 2023

Front. Immunol.

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The differing roles of the pentameric (p) and monomeric (m) C-reactive protein (CRP) isoforms in viral diseases are not fully understood, which was apparent during the COVID-19 pandemic regarding the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Herein, we investigated the predictive value of the pCRP and mCRP isoforms for COVID-19 severity in hospitalized patients and evaluated how the levels of the protein isoforms changed over time during and after acute illness. This study utilized samples from a well-characterized cohort of Swedish patients with SARS-CoV-2 infection, the majority of whom had known risk factors for severe COVID-19 and required hospitalization. The levels of pCRP were significantly raised in patients with severe COVID-19 and in contrast to mCRP the levels were significantly associated with disease severity. Additionally, the pCRP levels remained elevated for at least six weeks post inclusion, which was longer compared to the two weeks for mCRP. Our data indicates a low level of inflammation lasting for at least six weeks following COVID-19, which might indicate that the disease has an adverse effect on the immune system even after the viral infection is resolved. It is also clear that the current standard method of testing pCRP levels upon hospitalization is a useful marker for predicting disease severity and mCRP testing would not add any clinical relevance for patients with COVID-19.

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Antibody dynamics and viral load in COVID-19: differences in mild, moderate and severe cases

Ngoc,

Trifonova,

Christova

et al. 2023

Biotechnology & Biotechnological Equipment

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Viral load at hospitalization is an independent predictor of severe COVID‐19

Cited by 5 publications

References 41 publications

Major alterations to monocyte and dendritic cell subsets lasting more than 6 months after hospitalization for COVID-19

Major alterations to monocyte and dendritic cell subsets lasting more than 6 months after hospitalization for COVID-19

Pentameric C-reactive protein is a better prognostic biomarker and remains elevated for longer than monomeric CRP in hospitalized patients with COVID-19

Antibody dynamics and viral load in COVID-19: differences in mild, moderate and severe cases

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