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Secondary Complement Deficiency Impairs Anti-Microbial Immunity to and During Severe Acute COVID-19. | LitMetric

AI Article Synopsis

  • Severe COVID-19 patients showed a high rate of secondary infections, which might be linked to low levels of complement proteins C3 and C4 during the acute phase of the illness.
  • In a study of 217 severe COVID-19 patients, 142 developed secondary bacterial infections, with Klebsiella being the most common culprit.
  • The findings suggest that the overactivation of complement during acute infection could lead to a depletion that increases vulnerability to opportunistic infections.

Article Abstract

A high incidence of secondary and infection were observed in patients with severe COVID-19. The cause of this predisposition to infection is unclear. Our data demonstrate consumption of complement in acute COVID-19 patients reflected by low levels of C3, C4, and loss of haemolytic activity. Given that the elimination of Gram-negative bacteria depends in part on complement-mediated lysis, we hypothesised that secondary hypocomplementaemia is rendering the antibody-dependent classical pathway activation inactive and compromises serum bactericidal activity (SBA). 217 patients with severe COVID-19 were studied. 142 patients suffered secondary bacterial infections. Klebsiella species were the most common Gram-negative organism, found in 58 patients, while was the dominant Gram-positive organism found in 22 patients. Hypocomplementaemia was observed in patients with acute severe COVID-19 but not in convalescent survivors three months after discharge. Sera from patients with acute COVID-19 were unable to opsonise either or and had impaired complement-mediated killing of Klebsiella. We conclude that hyperactivation of complement during acute COVID-19 leads to secondary hypocomplementaemia and predisposes to opportunistic infections.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9094484PMC
http://dx.doi.org/10.3389/fimmu.2022.841759DOI Listing

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