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Two distinct immunopathological profiles in autopsy lungs of COVID-19

Author

Listed:
  • Ronny Nienhold

    (Cantonal Hospital Baselland)

  • Yari Ciani

    (University of Trento)

  • Viktor H. Koelzer

    (University Hospital Zurich
    University of Oxford)

  • Alexandar Tzankov

    (University Hospital Basel)

  • Jasmin D. Haslbauer

    (University Hospital Basel)

  • Thomas Menter

    (University Hospital Basel)

  • Nathalie Schwab

    (Cantonal Hospital Baselland)

  • Maurice Henkel

    (Cantonal Hospital Baselland)

  • Angela Frank

    (Cantonal Hospital Baselland)

  • Veronika Zsikla

    (Cantonal Hospital Baselland)

  • Niels Willi

    (Cantonal Hospital Baselland)

  • Werner Kempf

    (Kempf und Pfaltz Histologische Diagnostik)

  • Thomas Hoyler

    (Novartis Institutes for BioMedical Research (NIBR))

  • Mattia Barbareschi

    (Anatomia ed Istologia Patologica, Ospedale S. Chiara di Trento)

  • Holger Moch

    (University Hospital Zurich)

  • Markus Tolnay

    (University Hospital Basel)

  • Gieri Cathomas

    (Cantonal Hospital Baselland)

  • Francesca Demichelis

    (University of Trento
    Weill Cornell Medicine)

  • Tobias Junt

    (Novartis Institutes for BioMedical Research (NIBR))

  • Kirsten D. Mertz

    (Cantonal Hospital Baselland)

Abstract

Coronavirus Disease 19 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has grown to a worldwide pandemic with substantial mortality. Immune mediated damage has been proposed as a pathogenic factor, but immune responses in lungs of COVID-19 patients remain poorly characterized. Here we show transcriptomic, histologic and cellular profiles of post mortem COVID-19 (n = 34 tissues from 16 patients) and normal lung tissues (n = 9 tissues from 6 patients). Two distinct immunopathological reaction patterns of lethal COVID-19 are identified. One pattern shows high local expression of interferon stimulated genes (ISGhigh) and cytokines, high viral loads and limited pulmonary damage, the other pattern shows severely damaged lungs, low ISGs (ISGlow), low viral loads and abundant infiltrating activated CD8+ T cells and macrophages. ISGhigh patients die significantly earlier after hospitalization than ISGlow patients. Our study may point to distinct stages of progression of COVID-19 lung disease and highlights the need for peripheral blood biomarkers that inform about patient lung status and guide treatment.

Suggested Citation

  • Ronny Nienhold & Yari Ciani & Viktor H. Koelzer & Alexandar Tzankov & Jasmin D. Haslbauer & Thomas Menter & Nathalie Schwab & Maurice Henkel & Angela Frank & Veronika Zsikla & Niels Willi & Werner Kem, 2020. "Two distinct immunopathological profiles in autopsy lungs of COVID-19," Nature Communications, Nature, vol. 11(1), pages 1-13, December.
    • Handle: RePEc:nat:natcom:v:11:y:2020:i:1:d:10.1038_s41467-020-18854-2
    DOI: 10.1038/s41467-020-18854-2
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