Omar Mona A, El Hawary Rabab, Eldash Alia, Sadek Khaled M, Soliman Neveen A, Hanna Mariam Onsy F, Shawky Shereen M
Department of Clinical Pathology, Cairo University, Cairo, Egypt.
Department of Internal Medicine and Nephrology, Cairo University, Cairo, Egypt.
Lab Med. 2024 Mar 7;55(2):153-161. doi: 10.1093/labmed/lmad050.
While we strive to live with SARS-CoV-2, defining the immune response that leads to recovery rather than severe disease remains highly important. COVID-19 has been associated with inflammation and a profoundly suppressed immune response.
To study myeloid-derived suppressor cells (MDSCs), which are potent immunosuppressive cells, in SARS-CoV-2 infection.
Patients with severe and critical COVID-19 showed higher frequencies of neutrophilic (PMN)-MDSCs than patients with moderate illness and control individuals (P = .005). Severe disease in individuals older and younger than 60 years was associated with distinct PMN-MDSC frequencies, being predominantly higher in patients of 60 years of age and younger (P = .004). However, both age groups showed comparable inflammatory markers. In our analysis for the prediction of poor outcome during hospitalization, MDSCs were not associated with increased risk of death. Still, patients older than 60 years of age (odds ratio [OR] = 5.625; P = .02) with preexisting medical conditions (OR = 2.818; P = .003) showed more severe disease and worse outcome. Among the immunological parameters, increased C-reactive protein (OR = 1.015; P = .04) and lymphopenia (OR = 5.958; P = .04) strongly identified patients with poor prognosis.
PMN-MDSCs are associated with disease severity in COVID-19; however, MDSC levels do not predict increased risk of death during hospitalization.
在我们努力与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）共存的同时，明确导致康复而非重症疾病的免疫反应仍然至关重要。2019冠状病毒病（COVID-19）与炎症及严重受抑的免疫反应有关。
研究严重急性呼吸综合征冠状病毒2感染中具有强大免疫抑制作用的髓系来源抑制细胞（MDSC）。
与中度病情患者及对照个体相比，重型和危重型COVID-19患者的嗜中性粒细胞（PMN）-MDSC频率更高（P = 0.005）。60岁及以下和60岁以上个体的重症疾病与不同的PMN-MDSC频率相关，60岁及以下患者的频率主要更高（P = 0.004）。然而，两个年龄组的炎症标志物水平相当。在我们对住院期间不良结局预测的分析中，MDSC与死亡风险增加无关。尽管如此，但有基础疾病的60岁以上患者（比值比[OR]=5.625；P = 0.02）病情更严重，结局更差（OR = 2.818；P = 0.003）。在免疫参数中，C反应蛋白升高（OR = 1.015；P = 0.04）和淋巴细胞减少（OR = 5.958；P = 0.04）强烈提示患者预后不良。
PMN-MDSC与COVID-19疾病严重程度相关；然而，MDSC水平不能预测住院期间死亡风险增加。
