How certain comorbidities affect the severity of COVID-19

As of June 20, 2022, coronavirus 2 (SARS-CoV-2), the causative virus of coronavirus disease 2019 (COVID-19), has reached more than 544 million people. It has been infected and has killed more than 6.3 million people worldwide.

study: Existing comorbidities form an immune response associated with severe COVID-19. Image credits: shutter_o / Shutterstock.com

Background

Most people infected with SARS-CoV-2 experience mild symptoms or remain asymptomatic. However, a small number of people diagnosed with COVID-19 experience serious complications such as respiratory failure, pneumonia, and acute respiratory distress syndrome (ARDS).

Obtaining a medical history of COVID-19 patients, including the presence of underlying comorbidity, helps identify patients at high risk of developing serious illness. These patients may also be eligible for early therapeutic intervention and / or vaccination to further improve their survival outcome.

The most common comorbidities found in hospitalized COVID-19 patients include respiratory and cardiovascular disease, as well as obesity, diabetes, and hypertension. Cancer, chronic kidney disease, and immune disorders are also associated with severe infections.

Contradictory information remains about the extent to which certain comorbidities increase the risk of severe COVID-19. Further research is needed to determine how an individual’s previous immune status can determine their response to COVID-19.

As new therapies for the treatment of COVID-19 are approved worldwide, a better understanding of the immunopathological mechanism of SARS-CoV-2 comorbidities is essential. This information enables clinicians to provide optimized, personalized treatment for these patients.

new Journal of Allergy and Clinical Immunology The study reviews previous spectral flow datasets to assess the role of specific comorbidities in the immune response of patients infected with SARS-CoV-2.

Existing comorbidities form an immune response associated with severe COVID-19

About research

Current studies included collecting blood samples and clinical routine data from patients with COVID-19 from April 2020 to November 2020, as well as healthy controls. The severity of all COVID-19 patients is on a regular scale with the World Health Organization (WHO).

All COVID-19-related comorbidities are well defined, including obesity, heart disease, chronic renal disease, hypertension, lung disorders, cancer, diabetes, and immune disorders. Spectral flow data was analyzed to measure cytokine production in both lymphoid and myeloid cells.

Survey results

The COVID-19 patient cohort consisted of 60% male patients and 40% female patients. It was reported that men had a higher rate of severe infection than women.

Patients aged 65 years and older, and those with comorbidities, most commonly experienced severe COVID-19. In summary, 52.6% of patients reported the presence of multiple types of comorbidity.

Chronic kidney disease and obesity, apart from age, are important existing factors that increase an individual’s likelihood of experiencing severe COVID-19 when comparing patients with and without specific comorbidity. I found out. Chronic kidney disease and immune disorders have also been observed to have the most important effects on the SARS-CoV-2 immune response. Cancer, lung disorders, hypertensive obesity, type 2 diabetes, and heart disorders showed similar patterns.

Obese patients also have higher programmed death-1 (PD-1) expression in CD4 + T-regulated cells, granulocyte-macrophage colony stimulator (GM-CSF) expression in CD4 + T effector memory CD45RA + (TEMRA) cells, and CTLA-4 showed expression in CD4 + effector memory (EM) T cells.

By comparison, hypertensive patients showed reduced expression of CD4-CD8- (rich in TCRγδ) T cells and CD161, as well as higher expression of CD38. Patients with type 2 diabetes showed unconventional symptoms T cells Decreased expression of the profile and the co-stimulation signal CD86 in dendritic cells.

Immune signs in patients with lung disorders and heart disease also showed depleted, hyperactive natural killer (NK) and T cell subsets. In addition, COVID-19 patients with pre-existing immune disorders and chronic kidney disease have specific immunity, such as depleted overactive T cell compartments and impaired congenital and adaptive immunity, not observed in other comorbidity groups. Shown the function.

Conclusion

Current studies have confirmed an association between severe COVID-19 and certain comorbidities, and characterized the immune status of this infection based on the presence of certain existing medical conditions. Taken together, these findings help develop more personalized therapies for COVID-19 patients and ultimately reduce the severity of the disease.

Limitations

The current study used an actual cohort with a reduced number of COVID-19 patients with rare comorbidity. The second limitation was that most patients suffered from multiple comorbidities, which could bias the effects of comorbidities. Other factors such as gender. It could not be excluded due to the retrospective design of the study.