Immunoglobulin deficiency as an indicator of disease severity in patients with COVID-19.

Autor: Husain-Syed F; Divison of Nephrology, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy., Vadász I; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, German Center for Lung Research, Giessen, Germany.; The Cardio-Pulmonary Institute, Giessen, Germany., Wilhelm J; Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, German Center for Lung Research, Giessen, Germany.; The Cardio-Pulmonary Institute, Giessen, Germany.; Institute for Lung Health, Justus Liebig University Giessen, Giessen, Germany., Walmrath HD; Divison of Nephrology, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Division of Infectious Diseases, Department of Internal Medicine II, Department of Internal Medicine, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany., Seeger W; Divison of Nephrology, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Division of Infectious Diseases, Department of Internal Medicine II, Department of Internal Medicine, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, German Center for Lung Research, Giessen, Germany.; The Cardio-Pulmonary Institute, Giessen, Germany.; Institute for Lung Health, Justus Liebig University Giessen, Giessen, Germany.; Department of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany., Birk HW; Divison of Nephrology, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany., Jennert B; Divison of Nephrology, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany., Dietrich H; Divison of Nephrology, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany., Herold S; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Division of Infectious Diseases, Department of Internal Medicine II, Department of Internal Medicine, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, German Center for Lung Research, Giessen, Germany.; The Cardio-Pulmonary Institute, Giessen, Germany., Trauth J; Division of Infectious Diseases, Department of Internal Medicine II, Department of Internal Medicine, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany., Tello K; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, German Center for Lung Research, Giessen, Germany.; The Cardio-Pulmonary Institute, Giessen, Germany., Sander M; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany., Morty RE; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.; Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, German Center for Lung Research, Giessen, Germany.; The Cardio-Pulmonary Institute, Giessen, Germany.; Department of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany., Slanina H; Institute of Medical Virology, Justus Liebig University Giessen, The German Center for Infection Research, Giessen, Germany., Schüttler CG; Institute of Medical Virology, Justus Liebig University Giessen, The German Center for Infection Research, Giessen, Germany., Ziebuhr J; Institute of Medical Virology, Justus Liebig University Giessen, The German Center for Infection Research, Giessen, Germany., Kassoumeh S; Justus Liebig Medical University Medical School, Giessen, Germany., Ronco C; International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.; Department of Medicine (DIMED), Università di Padova, Padua, Italy., Ferrari F; Intensive Care Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy., Warnatz K; Center for Chronic Immunodeficiency at Center for Translational Research, Medical Center University of Freiburg, Freiburg, Germany., Stahl K; Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany., Seeliger B; Department of Respiratory Medicine and German Center for Lung Research, Hannover Medical School, Hannover, Germany., Hoeper MM; Department of Respiratory Medicine and German Center for Lung Research, Hannover Medical School, Hannover, Germany., Welte T; Department of Respiratory Medicine and German Center for Lung Research, Hannover Medical School, Hannover, Germany., David S; Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.; Institute for Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: American journal of physiology. Lung cellular and molecular physiology [Am J Physiol Lung Cell Mol Physiol] 2021 Apr 01; Vol. 320 (4), pp. L590-L599. Date of Electronic Publication: 2020 Nov 25.
DOI: 10.1152/ajplung.00359.2020
Abstrakt: Despite the pandemic status of COVID-19, there is limited information about host risk factors and treatment beyond supportive care. Immunoglobulin G (IgG) could be a potential treatment target. Our aim was to determine the incidence of IgG deficiency and associated risk factors in a cohort of 62 critically ill patients with COVID-19 admitted to two German ICUs (72.6% male, median age: 61 yr). Thirteen (21.0%) of the patients displayed IgG deficiency (IgG < 7 g/L) at baseline (predominant for the IgG1, IgG2, and IgG4 subclasses). Patients who were IgG-deficient had worse measures of clinical disease severity than those with normal IgG levels (shorter duration from disease onset to ICU admission, lower ratio of [Formula: see text] to [Formula: see text], higher Sequential Organ Failure Assessment score, and higher levels of ferritin, neutrophil-to-lymphocyte ratio, and serum creatinine). Patients who were IgG-deficient were also more likely to have sustained lower levels of lymphocyte counts and higher levels of ferritin throughout the hospital stay. Furthermore, patients who were IgG-deficient compared with those with normal IgG levels displayed higher rates of acute kidney injury (76.9% vs. 26.5%; P = 0.001) and death (46.2% vs. 14.3%; P = 0.012), longer ICU [28 (6-48) vs. 12 (3-18) days; P = 0.012] and hospital length of stay [30 (22-50) vs. 18 (9-24) days; P = 0.004]. Univariable logistic regression showed increasing odds of 90-day overall mortality associated with IgG-deficiency (odds ratio 5.14, 95% confidence interval 1.3-19.9; P = 0.018). IgG deficiency might be common in patients with COVID-19 who are critically ill, and warrants investigation as both a marker of disease severity as well as a potential therapeutic target.
Databáze: MEDLINE
Externí odkaz: