The aim of the present study is to examine the inflammatory response in the pulmonary compartment and blood of critically ill patients admitted to the ICU with COVID-19.
The mechanisms of the ARDS-like respiratory failure observed in patients with COVID-19 are currently unknown, but may be related to a distinct local immune response within the lung. In the present study, we will examine the cellular and humoral pulmonary immune response in mechanically ventilated patients admitted to the ICU with COVID-19 by examining immune cell profiles, cytokine patterns, and the complement pathway in bronchoalveolar lavage fluid, and relate it to the concomitant systemic inflammatory response. We will examine the patients on day 1-3 and 7-9 after ICU admission.
Study Type
OBSERVATIONAL
Enrollment
20
Dept. of Intensive Care 542, University Hospital Hvidovre
Hvidovre, Copenhagen, Denmark
White blood cell counts
Total white blood cells, neutrocytes, lymphocytes, and monocytes in bronchoalveolar lavage fluid and blood
Time frame: Day 0 (subsequent to study inclusion in the ICU)
White blood cell counts
Total white blood cells, neutrocytes, lymphocytes, and monocytes in bronchoalveolar lavage fluid and blood
Time frame: Day 7
Lymphocyte populations
Cell populations and subpopulations evaluated by 10 colored flow cytometry (B cells, T cells, TCR subsets, Tregs/Th17, dendritic cells, myeloid cells and neutrophils) in bronchoalveolar lavage fluid and blood
Time frame: Day 0 (subsequent to study inclusion in the ICU)
Lymphocyte populations
Cell populations and subpopulations evaluated by 10 colored flow cytometry (B cells, T cells, TCR subsets, Tregs/Th17, dendritic cells, myeloid cells and neutrophils) in bronchoalveolar lavage fluid and blood
Time frame: Day 7
Cytokines
Multiplex assay for measuring cytokines in bronchoalveolar lavage fluid and plasma (e.g. IL-1-beta, IL-1RA, IL-2, IL-6, IL-8, IL-10, IL-17, IL-18, IL-33, IL-35, TGF-beta, TNF-alpha, HMGB1)
Time frame: Day 0 (subsequent to study inclusion in the ICU)
Cytokines
Multiplex assay for measuring cytokines in bronchoalveolar lavage fluid and plasma (e.g. IL-1-beta, IL-1RA, IL-2, IL-6, IL-8, IL-10, IL-17, IL-18, IL-33, IL-35, TGF-beta, TNF-alpha, HMGB1)
Time frame: Day 7
Lectin complement pathway
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MBL, ficolin-1, ficolin-2, ficolin-3, and MASPs in bronchoalveolar lavage fluid and plasma
Time frame: Day 0 (subsequent to study inclusion in the ICU)
Lectin complement pathway
MBL, ficolin-1, ficolin-2, ficolin-3, and MASPs in bronchoalveolar lavage fluid and plasma
Time frame: Day 7
Microorganisms
Growth of pathogenic microorganisms in body fluids (e.g. urine, blood, bronchoalveolar lavage fluid)
Time frame: Up to 12 weeks
Respiratory pathogens
Respiratory filmarray PCR for testing for pathogens
Time frame: Day 0 (subsequent to study inclusion in the ICU)
Respiratory pathogens
Respiratory filmarray PCR for testing for pathogens
Time frame: Day 7
Ribosomal RNA in the airways
16S ribosomal RNA (rRNA) and 18S rRNA PCR for bacterial or fungal pathogen identification in bronchoalveolar lavage fluid
Time frame: Day 0 (subsequent to study inclusion in the ICU)
Ribosomal RNA in the airways
16S ribosomal RNA (rRNA) and 18S rRNA PCR for bacterial or fungal pathogen identification in bronchoalveolar lavage fluid
Time frame: Day 7
Levels of SARS-CoV-2 in the airways
Semiquant PCR of SARS-CoV-2 in bronchoalveolar lavage fluid
Time frame: Day 0 (subsequent to study inclusion in the ICU)
Levels of SARS-CoV-2 in the airways
Semiquant PCR of SARS-CoV-2 in bronchoalveolar lavage fluid
Time frame: Day 7
Surfactant in the airways
Measured in bronchoalveolar lavage fluid by fourier-transform infrared spectroscopy using the dipalmitoylphosphatidylcholine\[DPPC\]/spingomyelin\[SM\]) ratio
Time frame: Day 0
Autoantibodies against type I IFNs in the airways
Measured in bronchoalveolarlavage fluid
Time frame: Day 0