COVID-19 patients exhibit less pronounced immune suppression compared with bacterial septic shock patients
, on behalf of the RCI-COVID-19 study group, Matthijs Kox, Tim Frenzel, Jeroen Schouten, Frank L. van de Veerdonk, Hans J. P. M. Koenen, Peter Pickkers
Abstract
Low monocytic (m)HLA-DR expression is the most widely used marker of innate immune suppression in critically ill patients. We recently showed that in bacterial septic shock patients, low mHLA-DR expression is prevalent and associated with the development of secondary infections At the end of March 2020, there were in excess of 800,000 confirmed cases of coronavirus disease 2019 (COVID-19) worldwide, of whom more than 12,000 from the Netherlands. Several reports suggest that patients with severe COVID-19 may suffer from a hyperinflammatory "cytokine storm" [2, 3]. However, unlike SARS-CoV infection, high levels of antiinflammatory mediators (e.g. IL-10 and IL-4) have also been reported in . Although there are few indications that secondary infections are common in COVID-19 patients, one study reported that 16% of COVID-19 patients who died developed secondary infections Herein, we explored mHLA-DR expression kinetics in a cohort of 24 critically ill COVID-19 patients.