Complement Activation in the Disease Course of Coronavirus Disease 2019 and Its Effects on Clinical Outcomes.
Complement Activation in the Disease Course of Coronavirus Disease 2019 and Its Effects on Clinical Outcomes.
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DOI：
10.1093/infdis/jiaa646
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发表时间：
2021-02-03
期刊：
影响因子：
--
通讯作者：
RCI-COVID-19 study group
中科院分区：
文献类型：
--
作者：
de Nooijer AH;Grondman I;Janssen NAF;Netea MG;Willems L;van de Veerdonk FL;Giamarellos-Bourboulis EJ;Toonen EJM;Joosten LAB;RCI-COVID-19 study group
2019冠状病毒病（COVID-19）中免疫反应的过度激活被认为与疾病严重程度、并发症和死亡率有关。补体系统是先天免疫的重要组成部分，可以刺激炎症，但其在COVID-19中的作用尚不清楚。对COVID-19住院患者进行了一项前瞻性、纵向、单中心研究。在基线和住院期间评估补体因子C3a、C3c和终末补体复合体（TCC）的血浆浓度。同时，从医学档案中收集常规实验室和临床参数并进行分析。新冠肺炎患者血浆补体因子C3a、C3c、TCC与健康对照组比较，差异均有统计学意义（P < 0.05）。在整个病程中，这些补体因子在重症监护病房患者中尤其升高（P < 0.05）。C3a和TCC为005)。在死亡患者和有血栓栓塞事件的患者中观察到更强烈的补体激活。COVID-19患者表现出补体系统的激活，这与疾病严重程度有关。这一途径可能参与了与死亡率增加和血栓栓塞并发症相关的促炎反应失调。补体系统的组成部分可能有潜力作为疾病严重程度的预后标志物和COVID-19的治疗靶点。2019冠状病毒病（COVID-19）住院患者的补体系统持续激活，并与疾病严重程度和血栓栓塞并发症的发生有关。这些发现支持使用补体抑制剂治疗COVID-19重症患者的潜力。
Excessive activation of immune responses in coronavirus disease 2019 (COVID-19) is considered to be related to disease severity, complications, and mortality rate. The complement system is an important component of innate immunity and can stimulate inflammation, but its role in COVID-19 is unknown. A prospective, longitudinal, single center study was performed in hospitalized patients with COVID-19. Plasma concentrations of complement factors C3a, C3c, and terminal complement complex (TCC) were assessed at baseline and during hospital admission. In parallel, routine laboratory and clinical parameters were collected from medical files and analyzed. Complement factors C3a, C3c, and TCC were significantly increased in plasma of patients with COVID-19 compared with healthy controls (P < .05). These complement factors were especially elevated in intensive care unit patients during the entire disease course (P < .005 for C3a and TCC). More intense complement activation was observed in patients who died and in those with thromboembolic events. Patients with COVID-19 demonstrate activation of the complement system, which is related to disease severity. This pathway may be involved in the dysregulated proinflammatory response associated with increased mortality rate and thromboembolic complications. Components of the complement system might have potential as prognostic markers for disease severity and as therapeutic targets in COVID-19. The complement system is persistently activated in hospitalized patients with coronavirus disease 2019 (COVID-19) and associated with disease severity and onset of thromboembolic complications. These findings support the potential use of complement inhibitors to treat severely ill patients with COVID-19.
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