Journalartikel
Autorenliste: Husain-Syed, Faeq; Vadasz, Istvan; Wilhelm, Jochen; Walmrath, Hans-Dieter; Seeger, Werner; Birk, Horst-Walter; Jennert, Birgit; Dietrich, Hartmut; Herold, Susanne; Trauth, Janina; Tello, Khodr; Sander, Michael; Morty, Rory E.; Slanina, Heiko; Schuttler, Christian G.; Ziebuhr, John; Kassoumeh, Shadi; Ronco, Claudio; Ferrari, Fiorenza; Warnatz, Klaus; Stahl, Klaus; Seeliger, Benjamin; Hoeper, Marius M.; Welte, Tobias; David, Sascha
Jahr der Veröffentlichung: 2021
Seiten: L590-L599
Zeitschrift: American Journal of Physiology - Lung Cellular and Molecular Physiology
Bandnummer: 320
Heftnummer: 4
ISSN: 1040-0605
eISSN: 1522-1504
Open Access Status: Green
DOI Link: https://doi.org/10.1152/ajplung.00359.2020
Verlag: American Physiological Society
Abstract:
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 Pa-O2 to FIO2, 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 (2250) 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.
Zitierstile
Harvard-Zitierstil: Husain-Syed, F., Vadasz, I., Wilhelm, J., Walmrath, H., Seeger, W., Birk, H., et al. (2021) Immunoglobulin deficiency as an indicator of disease severity in patients with COVID-19, American Journal of Physiology - Lung Cellular and Molecular Physiology, 320(4), pp. L590-L599. https://doi.org/10.1152/ajplung.00359.2020
APA-Zitierstil: Husain-Syed, F., Vadasz, I., Wilhelm, J., Walmrath, H., Seeger, W., Birk, H., Jennert, B., Dietrich, H., Herold, S., Trauth, J., Tello, K., Sander, M., Morty, R., Slanina, H., Schuttler, C., Ziebuhr, J., Kassoumeh, S., Ronco, C., Ferrari, F., ...David, S. (2021). Immunoglobulin deficiency as an indicator of disease severity in patients with COVID-19. American Journal of Physiology - Lung Cellular and Molecular Physiology. 320(4), L590-L599. https://doi.org/10.1152/ajplung.00359.2020
Schlagwörter
cytokine release syndrome; immunodysregulation; respiratory failure; severe acute respiratory syndrome coronavirus 2
