4.7 Article

B cell depletion and signs of sepsis-acquired immunodeficiency in bone marrow and spleen of COVID-19 deceased

期刊

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
卷 103, 期 -, 页码 628-635

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ELSEVIER SCI LTD
DOI: 10.1016/j.ijid.2020.12.078

关键词

COVID-19; SARS-CoV-2; Bone marrow; Spleen; B cells; Sepsis; Immunodeficiency; Humoral immune response

资金

  1. German Research Foundation (DFG)
  2. Open Access Publication Fund of Charite Universitatsmedizin Berlin

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The study revealed that severe COVID-19 pneumonia with bacterial infection may lead to sepsis-related immunodeficiency. Additionally, lymphocytopenia in COVID-19 patients is accompanied by B cell depletion in hematopoietic tissue, which could impact the durability of the humoral immune response to SARS-CoV-2.
Objectives: In coronavirus disease 2019 (COVID-19), the adaptive immune response is of considerable importance, and detailed cellular immune reactions in the hematological system of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are yet to be clarified. Methods: This study reports the morphological characterization of both bone marrow and spleen in 11 COVID-19 decedents with respect to findings in the peripheral blood and pulmonary SARS-CoV-2 burden. Results: In the bone marrow, activation and left shift were found in at least 55% of patients, which was mirrored by peripheral anaemia, granulocytic immaturity and multiple thromboembolic events. Signs of sepsis-acquired immunodeficiency were found in the setting of an abscess-forming superinfection of viral COVID-19 pneumonia. Furthermore, a severe B cell loss was observed in the bone marrow and/or spleen in 64% of COVID-19 patients. This was reflected by lymphocytopenia in the peripheral blood. As compared to B cell preservation, B cell loss was associated with a higher pulmonary SARS-CoV-2 burden and only a marginal decrease of of T cell counts. Conclusions: The results of this study suggest the presence of sepsis-related immunodeficiency in severe COVID-19 pneumonia with superinfection. Furthermore, our findings indicate that lymphocytopenia in COVID-19 is accompanied by B cell depletion in hematopoietic tissue, which might impede the durability of the humoral immune response to SARS-CoV-2. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

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