Asthma and COPD Are Not Risk Factors for ICU Stay and Death in Case of SARS-CoV2 Infection

BACKGROUND: Asthmatics and patients with chronic obstructive pulmonary disease (COPD) have more severe outcomes with viral infections than people without obstructive disease. OBJECTIVE: To evaluate if obstructive diseases are risk factors for intensive care unit (ICU) stay and death due to coronavirus disease 2019 (COVID19). METHODS: We collected data from the electronic medical record from 596 adult patients hospitalized in University Hospital of Liege between March 18 and April 17, 2020, for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. We classified patients into 3 groups according to the underlying respiratory disease, present before the COVID19 pandemic. RESULTS: Among patients requiring hospitalization for COVID19, asthma and COPD accounted for 9.6% and 7.7%, respectively. The proportions of asthmatics, patients with COPD, and patients without obstructive airway disease hospitalized in the ICU were 17.5%, 19.6%, and 14%, respectively. One-third of patients with COPD died during hospitalization, whereas only 7.0% of asthmatics and 13.6% of patients without airway obstruction died due to SARS-CoV2. The multivariate analysis showed that asthma, COPD, inhaled corticosteroid treatment, and oral corticosteroid treatment were not independent risk factors for ICU admission or death. Male gender (odds ratio [OR]: 1.9; 95% confidence interval [CI]: 1.1-3.2) and obesity (OR: 8.5; 95% CI: 5.1-14.1) were predictors of ICU admission, whereas male gender (OR 1.9; 95% CI: 1.1-3.2), older age (OR: 1.9; 95% CI: 1.6-2.3), cardiopathy (OR: 1.8; 95% CI: 1.1-3.1), and immunosuppressive diseases (OR: 3.6; 95% CI: 1.5-8.4) were independent predictors of death. CONCLUSION: Asthma and COPD are not risk factors for ICU admission and death related to SARS-CoV2 infection

Impact of TRECs on sCD14 (N = 75), taking into account patients’ characteristics^*.

<p>Impact of TRECs on sCD14 (N = 75), taking into account patients’ characteristics^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0185761#t004fn001" target="_blank">*</a>}.</p

General comparison of data selected for the sex or the ethnicity.

<p>A. Impact of the sex on some observed data. Men have higher CD8 (p = 0.012) levels but lower TRECsj (p = 0.0003) and ratio of TREC (p = 0.012) than women. B. Impact of the ethnicity. Caucasians have higher CD4 (p = 0.0073) levels and sCD14 (p = 0.0054) but lower TRECsj (p = 0.015) than people from African Origin.</p

Impact of the sex on observed blood markers of 75 HIV+ subjects.

<p>Impact of the sex on observed blood markers of 75 HIV+ subjects.</p

Impact of ethnicity on observed blood markers of 75 HIV+ subjects.

<p>Impact of ethnicity on observed blood markers of 75 HIV+ subjects.</p

Impact of TRECs on sCD14^* (N = 75).

<p>Impact of TRECs on sCD14^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0185761#t003fn001" target="_blank">*</a>} (N = 75).</p

Exploring the link between innate immune activation and thymic function by measuring sCD14 and TRECs in HIV patients living in Belgium

Microbial translocation is now viewed as a central event in the pathogenesis of chronic inflammation during HIV infection. Thymic function failure is another crucial factor involved in HIV disease progression. The goal of this study was to explore the hypothesis of potential links between microbial translocation and thymic function in HIV-1 patients living in Belgium. The extent of microbial translocation was assessed through the measurement of soluble CD14 (sCD14). T-cell receptor excision circles (sjTRECs and dβTRECs) were used as a measure of thymic function. Data were collected from 75 HIV-infected patients. Simple and complex linear regressions were done to analyze the link between these two processes. We found a statistically relevant negative correlation between thymopoiesis (sjTREC) and sCD14 level (p = 0.004). These results suggest a link between thymic function failure, microbial translocation and innate immune activation