Gonzalez Filipe André, Ângelo-Dias Miguel, Martins Catarina, Gomes Rui, Bacariza Jacobo, Fernandes Antero, Borrego Luís Miguel
Intensive Care Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal.
CEDOC-Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, 1099-085 Lisbon, Portugal.
J Clin Med. 2022 Mar 28;11(7):1880. doi: 10.3390/jcm11071880.
Background: We aimed to explore immune parameters in COVID-19 patients admitted to the intensive care unit (ICU) to identify distinctive features in patients with cardiac injury. Methods: A total of 30 COVID-19 patients >18 years admitted to the ICU were studied on days D1, D3 and D7 after admission. Cardiac function was assessed using speckle-tracking echocardiography (STE). Peripheral blood immunophenotyping, cardiac (pro-BNP; troponin) and inflammatory biomarkers were simultaneously evaluated. Results: Cardiac dysfunction (DYS) was detected by STE in 73% of patients: 40% left ventricle (LV) systolic dysfunction, 60% LV diastolic dysfunction, 37% right ventricle systolic dysfunction. High-sensitivity cardiac troponin (hs-cTn) was detectable in 43.3% of the patients with a median value of 13.00 ng/L. There were no significant differences between DYS and nDYS patients regarding mortality, organ dysfunction, cardiac (including hs-cTn) or inflammatory biomarkers. Patients with DYS showed persistently lower lymphocyte counts (median 896 [661−1837] cells/µL vs. 2141 [924−3306] cells/µL, p = 0.058), activated CD3 (median 85 [66−170] cells/µL vs. 186 [142−259] cells/µL, p = 0.047) and CD4 T cells (median 33 [28−40] cells/µL vs. 63 [48−79] cells/µL, p = 0.005), and higher effector memory T cells (TEM) at baseline (CD4%: 10.9 [6.4−19.2] vs. 5.9 [4.2−12.8], p = 0.025; CD8%: 15.7 [7.9−22.8] vs. 8.1 [7.7−13.7], p = 0.035; CD8 counts: 40 cells/µL [17−61] vs. 10 cells/µL [7−17], p = 0.011) than patients without cardiac dysfunction. Conclusion: Our study suggests an association between the immunological trait and cardiac dysfunction in severe COVID-19 patients.
我们旨在探究入住重症监护病房（ICU）的新型冠状病毒肺炎（COVID-19）患者的免疫参数，以确定心脏损伤患者的独特特征。方法：对30例年龄>18岁入住ICU的COVID-19患者在入院后第1天、第3天和第7天进行研究。使用斑点追踪超声心动图（STE）评估心脏功能。同时评估外周血免疫表型、心脏（脑钠肽前体；肌钙蛋白）和炎症生物标志物。结果：STE检测到73%的患者存在心脏功能障碍（DYS）：40%为左心室（LV）收缩功能障碍，60%为LV舒张功能障碍，37%为右心室收缩功能障碍。43.3%的患者可检测到高敏心肌肌钙蛋白（hs-cTn），中位值为13.00 ng/L。在死亡率、器官功能障碍、心脏（包括hs-cTn）或炎症生物标志物方面，DYS患者和无DYS患者之间无显著差异。DYS患者的淋巴细胞计数持续较低（中位数896 [661 - 1837] 个细胞/µL vs. 2141 [924 - 3306] 个细胞/µL，p = 0.058）、活化CD3（中位数85 [66 - 170] 个细胞/µL vs. 186 [142 - 259] 个细胞/µL，p = 0.047）和CD4 T细胞（中位数33 [28 - 40] 个细胞/µL vs. 63 [48 - 79] 个细胞/µL，p = 0.005），且基线时效应记忆T细胞（TEM）较高（CD4%：10.9 [6.4 - 19.2] vs. 5.9 [4.2 - 12.8]，p = 0.025；CD8%：15.7 [7.9 - 22.8] vs. 8.1 [7.7 - 13.7]，p = 0.035；CD8计数：40个细胞/µL [17 - 61] vs. 10个细胞/µL [7 - 17]，p = 0.011），高于无心脏功能障碍的患者。结论：我们的研究表明，重症COVID-19患者的免疫特征与心脏功能障碍之间存在关联。
