Comparative immune profiling of acute respiratory distress syndrome patients with or without SARS-CoV-2 infection
Mikaël Roussel, Juliette Ferrant, Florian Reizine, Simon Le Gallou, Joëlle Dulong, Sarah H. Carl, Matheiu Lesouhaitier, Murielle Grégoire, Nadège Bescher, Clotilde Verdy, Maëlle Latour, Isabelle Bézier, Marie Cornic, Angélique Vinit, Céline Monvoisin, Birgit Sawitzki, Simon Léonard, Stéphane Paul, Jean Feuillard, Robin Jeannet, Thomas Daix, Vijay Tiwari, Jean‐Marc Tadié, Michel Cogné, Karin Tarte
Abstract
Acute respiratory distress syndrome (ARDS) is the main complication of coronavirus disease 2019 (COVID-19), requiring admission to the intensive care unit (ICU). Despite extensive immune profiling of COVID-19 patients, to what extent COVID-19-associated ARDS differs from other causes of ARDS remains unknown. To address this question, here, we build 3 cohorts of patients categorized in COVID-19 − ARDS + , COVID-19 + ARDS + , and COVID-19 + ARDS − , and compare, by high-dimensional mass cytometry, their immune landscape. A cell signature associating S100A9/calprotectin-producing CD169 + monocytes, plasmablasts, and Th1 cells is found in COVID-19 + ARDS + , unlike COVID-19 − ARDS + patients. Moreover, this signature is essentially shared with COVID-19 + ARDS − patients, suggesting that severe COVID-19 patients, whether or not they experience ARDS, display similar immune profiles. We show an increase in CD14 + HLA-DR low and CD14 low CD16 + monocytes correlating to the occurrence of adverse events during the ICU stay. We demonstrate that COVID-19-associated ARDS displays a specific immune profile and may benefit from personalized therapy in addition to standard ARDS management.