Immunphänotypisierung der myelomonozytären Zellen bei Patienten mit COVID-19 Erkrankung
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Philipps-Universität Marburg
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Abstract
The newly described coronavirus SARS-CoV-2 (severe acute respiratory syndrome
coronavirus type 2) first appeared in the Chinese city of Wuhan in December 2019 and has
since spread with enormous dynamics across the globe. On March 11, 2020, the WHO officially
declared the designated COVID-19 disease caused by SARS-CoV-2 as a pandemic. The
clinical appearance varies between asymptomatic cases, mild symptoms up to the most severe
courses that require hospitalization or even intensive medical treatment. In particular, severe
pneumonia in the context of COVID-19 disease with the need for ventilation and subsequent
lung failure (acute respiratory distress syndrome, ARDS) is a clinical challenge. COVID-19 also
shows systemic manifestations and can be accompanied by a dysregulated immune response,
which is associated with an increased mortality. As a result, the aim of this work was to record
the immunological changes in COVID-19 patients by means of flow cytometric analyzes and
to identify COVID-specific differences between mild and severe disease courses. The better
understanding should enable supportive diagnostics as well as early risk stratification to
optimize the therapy.
The study population comprised 25 patients who were admitted to Marburg University Hospital
between March 19, 2020 and June 17, 2020 with the COVID-typical ground-glass opacity in
imaging. Based on the test result from the RT-PCR, patients were divided into a SARS-CoV-2
positive (N = 16) and a SARS-CoV-2 negative (N = 9) population and, regardless of the test
result, into an intensive and a non-intensive group. The 18 ICU-patients were considered
representative of a severe course and were examined for possible COVID- 19 specific markers
that could predict disease severity. We used Receiver Operating Characteristic (ROC) analysis
to examine parameters for their ability to differentiate between SARS-CoV-2 positive and
SARS-CoV-2 negative patients. In addition, a correlation matrix according to Spearman was
created for various cell rows to determine COVID-specific parameters that are associated with
disease severity within the intensive group.
Our results showed that the patients with COVID-19 not only had a longer median length of
stay in hospital and longer time in an intensive care unit, but also had a significantly more
frequent and more serious lung failure (ARDS) with significantly longer invasive ventilation than
in the control group. Moreover, the death counts of the SARS-CoV-2 positive patients were
higher compared to the negative control group. However, the majority could be discharged.
The multiparameter flow cytometry analysis of the myeloid cell series showed that neutrophil
granulocytes with a low CD15 expression (difference ± SD; 295,70 ± 117,50 MFI; p = 0,02)
and diminished granularity (difference ± SD; 1,11 ± 0,43 side-scatter ratio; p = 0,02) were
characteristic of COVID-19 pneumonia, while non-classical and intermediate monocytes are
increasingly present in the monocyte compartment in patients with COVID-19. In addition, severe COVID-19 infection was correlated with a low CD16 expression (r = -0,72, p = 0,01,
95%-CI [-0,92; -0,23]) and high CD64 expression (r = 0,76, p = 0,01, 95%-CI [0,31; 0,93]) in
the neutrophil granulocytes, and ARDS was correlated with CD36 expression (r = 0,66, p =
0,03, 95%-CI [0,07; 0,91]).
In this work it was confirmed that the COVID-19 disease is related to characteristic changes in
the blood count, which are recorded by flow cytometry and can also be included in the
diagnosis of the COVID-19 disease to enable early risk stratification.
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Created: 2025Issued: 2025-05-15Updated: 2025-05-15
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
FACS, myeloid cells, CD16, CD64, CD36, CD14, CD15, fc Gamma receptor, monocytesFlow cytometry
DFG-subjects
DurchflusszytometrieCoronaSARS-CoV-2COVID-19
DDC-Numbers
610
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Etati-Kramm, Rojin: Immunphänotypisierung der myelomonozytären Zellen bei Patienten mit COVID-19 Erkrankung. : Philipps-Universität Marburg 2025-05-15. DOI: https://doi.org/10.17192/z2025.0207.
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This item has been published with the following license: In Copyright