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Langnau C, Janing H, Kocaman H, Gekeler S, Günter M, Petersen-Uribe Á, Jaeger P, Koch B, Kreisselmeier KP, Castor T, Rath D, Gawaz MP, Autenrieth SE, Mueller KAL. Recovery of systemic hyperinflammation in patients with severe SARS-CoV-2 infection. Biomarkers 2023; 28:97-110. [PMID: 36377411 DOI: 10.1080/1354750x.2022.2148745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Patients with cardiovascular disease (CVD) and acute SARS-CoV-2 infection might show an altered immune response during COVID-19. MATERIAL AND METHODS Twenty-three patients with CVD and SARS-CoV-2 infection were prospectively enrolled and received a cardiological assessment at study entry and during follow-up visit. Inclusion criteria of our study were age older than 18 years, presence of CVD, and acute SARS-CoV-2 infection. The median age of the patient cohort was 69 (IQR 55-79) years. 12 (52.2%) patients were men. Peripheral monocytes and chemokine/cytokine profiles were analysed. RESULTS Numbers of classical and non-classical monocytes were significantly decreased during acute SARS-CoV-2 infection compared to 3-month recovery. While classical monocytes reached the expected level in peripheral blood after 3 months, the number of non-classical monocytes remained significantly reduced. DISCUSSION All three monocyte subsets exhibited changes of established adhesion and activation markers. Interestingly, they also expressed higher levels of pro-inflammatory cytokines like macrophage migration inhibitory factor (MIF) at the time of recovery, although MIF was only slightly increased during the acute phase. CONCLUSION Changes of monocyte phenotypes and increased MIF expression after 3-month recovery from acute SARS-CoV-2 infection may indicate persistent, possibly long-lasting, pro-inflammatory monocyte function in CVD patients.
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Affiliation(s)
- Carolin Langnau
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Henrik Janing
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Hüseyin Kocaman
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Sarah Gekeler
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Manina Günter
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany.,Department of Dendritic Cells in Infection and Cancer, German Cancer Research Centre, Heidelberg, Germany
| | - Álvaro Petersen-Uribe
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Philippa Jaeger
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Barbara Koch
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Klaus-Peter Kreisselmeier
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Tatsiana Castor
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Dominik Rath
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Meinrad Paul Gawaz
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Stella E Autenrieth
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany.,Department of Dendritic Cells in Infection and Cancer, German Cancer Research Centre, Heidelberg, Germany
| | - Karin Anne Lydia Mueller
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
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Mizera L, Zdanyte M, Gernert J, Petersen-Uribe Á, Müller K, Gawaz MP, Greulich S, Rath D. COVID-19 versus seasonal influenza: myocardial injury and prognostic importance. BMC Infect Dis 2022; 22:539. [PMID: 35692037 PMCID: PMC9188910 DOI: 10.1186/s12879-022-07488-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/25/2022] [Indexed: 11/28/2022] Open
Abstract
Background Acute myocardial injury is associated with poor prognosis in respiratory tract infections. We aimed to highlight the differences in prevalence of myocardial injury and its impact on prognosis in patients with COVID-19 compared to those with seasonal influenza. Methods This was a single-center prospective cohort study with a historical control group. 300 age-/sex-matched SARS-CoV-2 and seasonal influenza positive patients were enrolled. Myocardial injury was assessed by electrocardiogram (ECG), transthoracic echocardiography and biomarkers including high-sensitivity troponin-I. All patients were followed-up for 30 days after enrollment for all-cause mortalitiy, admission to the intensive care unit (ICU) and mechanical ventilation. Results Right ventricular distress was more common in COVID-19 whereas pathological ECG findings and impaired left ventricular function were more prevalent among influenza patients. COVID-19 patients suffered from a higher percentage of hypertension and dyslipidaemia. Contrary to COVID-19, pericardial effusion at admission was associated with poor outcome in the influenza group. Severe course of disease and respiratory failure resulted in significantly higher rates of ICU treatment and mechanical ventilation in COVID-19 patients. Although distribution of myocardial injury was similar, significantly fewer cardiac catheterizations were performed in COVID-19 patients. However, number of cardiac catheterizations was low in both groups. Finally, 30-day mortality was significantly higher in COVID-19 compared to influenza patients. Conclusions In adults requiring hospitalization due to COVID-19 or seasonal influenza, cardiovascular risk factors and signs of myocardial distress differ significantly. Furthermore, cardiovascular comorbidities may impair prognosis in COVID-19 patients to a higher degree than in their influenza counterparts.
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Affiliation(s)
- Lars Mizera
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany
| | - Monika Zdanyte
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany
| | - Johannes Gernert
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany
| | - Álvaro Petersen-Uribe
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany
| | - Karin Müller
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany
| | - Meinrad Paul Gawaz
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany
| | - Simon Greulich
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany
| | - Dominik Rath
- Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany.
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Langnau C, Rohlfing AK, Gekeler S, Günter M, Pöschel S, Petersen-Uribe Á, Jaeger P, Avdiu A, Harm T, Kreisselmeier KP, Castor T, Bakchoul T, Rath D, Gawaz MP, Autenrieth SE, Mueller KAL. Platelet Activation and Plasma Levels of Furin Are Associated With Prognosis of Patients With Coronary Artery Disease and COVID-19. Arterioscler Thromb Vasc Biol 2021; 41:2080-2096. [PMID: 33910372 PMCID: PMC8147700 DOI: 10.1161/atvbaha.120.315698] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/08/2021] [Indexed: 02/06/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Carolin Langnau
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Anne-Katrin Rohlfing
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Sarah Gekeler
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Manina Günter
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology (M.G., S.P., S.E.A.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
- Department of Dendritic Cells in Infection and Cancer, German Cancer Research Centre, Heidelberg (M.G., S.E.A.)
| | - Simone Pöschel
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology (M.G., S.P., S.E.A.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Álvaro Petersen-Uribe
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Philippa Jaeger
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Alban Avdiu
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Tobias Harm
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Klaus-Peter Kreisselmeier
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Tatsiana Castor
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Tamam Bakchoul
- Department of Clinical and Experimental Transfusion Medicine (T.B.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Dominik Rath
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Meinrad Paul Gawaz
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Stella E. Autenrieth
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology (M.G., S.P., S.E.A.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
- Department of Dendritic Cells in Infection and Cancer, German Cancer Research Centre, Heidelberg (M.G., S.E.A.)
| | - Karin Anne Lydia Mueller
- Department of Cardiology and Angiology (C.L., A.-K.R., S.G., Á.P.-U., P.J., A.A., T.H., K.-P.K., T.C., D.R., M.P.G., K.A.L.M.), University Hospital Tuebingen, Eberhard Karls University Tuebingen, Germany
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Mueller KAL, Langnau C, Günter M, Pöschel S, Gekeler S, Petersen-Uribe Á, Kreisselmeier KP, Klingel K, Bösmüller H, Li B, Jaeger P, Castor T, Rath D, Gawaz MP, Autenrieth SE. Numbers and phenotype of non-classical CD14dimCD16+ monocytes are predictors of adverse clinical outcome in patients with coronary artery disease and severe SARS-CoV-2 infection. Cardiovasc Res 2021; 117:224-239. [PMID: 33188677 PMCID: PMC7665325 DOI: 10.1093/cvr/cvaa328] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/24/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS To elucidate the prognostic role of monocytes in the immune response of patients with coronary artery disease (CAD) at risk for life-threatening heart and lung injury as major complications of SARS-CoV-2 infection. METHODS AND RESULTS From February to April 2020, we prospectively studied a cohort of 96 participants comprising 47 consecutive patients with CAD and acute SARS-CoV-2 infection (CAD + SARS-CoV-2), 19 CAD patients without infections, and 30 healthy controls. Clinical assessment included blood sampling, echocardiography, and electrocardiography within 12 h of admission. Respiratory failure was stratified by the Horovitz Index (HI) as moderately/severely impaired when HI ≤200 mmHg. The clinical endpoint (EP) was defined as HI ≤200 mmHg with subsequent mechanical ventilation within a follow-up of 30 days. The numbers of CD14dimCD16+ non-classical monocytes in peripheral blood were remarkably low in CAD + SARS-CoV-2 compared with CAD patients without infection and healthy controls (P < 0.0001). Moreover, these CD14dimCD16 monocytes showed decreased expression of established markers of adhesion, migration, and T-cell activation (CD54, CD62L, CX3CR1, CD80, and HLA-DR). Decreased numbers of CD14dimCD16+ monocytes were associated with the occurrence of EP. Kaplan-Meier curves illustrate that CAD + SARS-CoV-2 patients with numbers below the median of CD14dimCD16+ monocytes (median 1443 cells/mL) reached EP significantly more often compared to patients with numbers above the median (log-rank 5.03, P = 0.025). CONCLUSION Decreased numbers of CD14dimCD16+ monocytes are associated with rapidly progressive respiratory failure in CAD + SARS-CoV-2 patients. Intensified risk assessments comprising monocyte sub- and phenotypes may help to identify patients at risk for respiratory failure.
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Affiliation(s)
- Karin Anne Lydia Mueller
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Carolin Langnau
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Manina Günter
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Simone Pöschel
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Sarah Gekeler
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Álvaro Petersen-Uribe
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Klaus-Peter Kreisselmeier
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Karin Klingel
- Department of Molecular Pathology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Hans Bösmüller
- Department of Molecular Pathology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Bo Li
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Philippa Jaeger
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Tatsiana Castor
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Dominik Rath
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Meinrad Paul Gawaz
- Department of Cardiology and Angiology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Otfried-Müller Str.10, 72076 Tuebingen, Germany
| | - Stella E Autenrieth
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
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