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https://www.arca.fiocruz.br/handle/icict/62709
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2030-12-31
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- INI - Artigos de Periódicos [3502]
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IMPACT OF THE IMMUNE PROFILES OF HYPERTENSIVE PATIENTS WITH AND WITHOUT OBESITY ON COVID-19 SEVERITY
Author
Moll-Bernardes, Renata
Ferreira, Juliana R.
Sousa, Andréa Silvestre
Tortelly, Mariana B.
Pimentel, Adriana L.
Figueiredo, Ana Cristina B. S.
Schaustz, Eduardo B.
Secco, José Carlos Pizzolante
Sales, Allan Robson Kluser
Terzi, Flavia V. O.
Brito, Adriana Xavier de
Sarmento, Renée O.
Noya-Rabelo, Marcia M.
Fortier, Sergio
Silva, Flavia A. Matos e
Vera, Narendra
Conde, Luciana
Cabral-Castro, Mauro Jorge
Albuquerque, Denilson C.
de-Castro, Paulo Rosado
Camargo, Gabriel C.
Pinheiro, Martha V. T.
Souza, Olga F.
Bozza, Fernando A.
Luiz, Ronir R.
Medei, Emiliano
Ferreira, Juliana R.
Sousa, Andréa Silvestre
Tortelly, Mariana B.
Pimentel, Adriana L.
Figueiredo, Ana Cristina B. S.
Schaustz, Eduardo B.
Secco, José Carlos Pizzolante
Sales, Allan Robson Kluser
Terzi, Flavia V. O.
Brito, Adriana Xavier de
Sarmento, Renée O.
Noya-Rabelo, Marcia M.
Fortier, Sergio
Silva, Flavia A. Matos e
Vera, Narendra
Conde, Luciana
Cabral-Castro, Mauro Jorge
Albuquerque, Denilson C.
de-Castro, Paulo Rosado
Camargo, Gabriel C.
Pinheiro, Martha V. T.
Souza, Olga F.
Bozza, Fernando A.
Luiz, Ronir R.
Medei, Emiliano
Affilliation
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP,Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Disease. Clinical Research Laboratory in Intensive Medicine. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rio de Janeiro Federal State University. Internal Medicine Department. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil / Bahia School of Medicine and Public Health. Salvador, BA, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro. Institute of Biophysics Carlos Chagas Filho,. Rio de Janeiro, RJ, Brazil.
Bahia School of Medicine and Public Health. Salvador, BA, Brazil.
Federal University of Rio de Janeiro. Institute of Microbiology Paulo de Góes. Rio de Janeiro, RJ, Brazil / Fluminense Federal University. Faculty of Medicine. Department of Pathology. Niterói, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rio de Janeiro State University. Cardiology Department. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Disease. Clinical Research Laboratory in Intensive Medicine. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Institute for Studies in Public Health. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. National Center for Structural Biology and Bioimaging. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP,Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Disease. Clinical Research Laboratory in Intensive Medicine. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rio de Janeiro Federal State University. Internal Medicine Department. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil / Bahia School of Medicine and Public Health. Salvador, BA, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro. Institute of Biophysics Carlos Chagas Filho,. Rio de Janeiro, RJ, Brazil.
Bahia School of Medicine and Public Health. Salvador, BA, Brazil.
Federal University of Rio de Janeiro. Institute of Microbiology Paulo de Góes. Rio de Janeiro, RJ, Brazil / Fluminense Federal University. Faculty of Medicine. Department of Pathology. Niterói, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rio de Janeiro State University. Cardiology Department. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D’Or São Luiz. Cardiology and Internal Medicine Department. São Paulo, SP, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Disease. Clinical Research Laboratory in Intensive Medicine. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Institute for Studies in Public Health. Rio de Janeiro, RJ, Brazil.
D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. National Center for Structural Biology and Bioimaging. Rio de Janeiro, RJ, Brazil.
Abstract
Background: Comorbidities such as obesity, hypertension, and diabetes are associated with COVID-19 development and severity, probably due to immune dysregulation; however, the mechanisms underlying these associations are not clear. The immune signatures of hypertensive patients with obesity with COVID-19 may provide new insight into the mechanisms of immune dysregulation and progression to severe disease in these patients. Methods: Hypertensive patients were selected prospectively from a multicenter registry of adults hospitalized with COVID-19 and stratified according to obesity (BMI ≥ 30 kg/m²). Clinical data including baseline characteristics, complications, treatment, and 46 immune markers were compared between groups. Logistic regression was performed to identify variables associated with the risk of COVID-19 progression in each group. Results: The sample comprised 213 patients (89 with and 124 without obesity). The clinical profiles of patients with and without obesity differed, suggesting potential interactions with COVID-19 severity. Relative to patients without obesity, patients with obesity were younger and fewer had cardiac disease and myocardial injury. Patients with obesity had higher EGF, GCSF, GMCSF, interleukin (IL)-1ra, IL-5, IL-7, IL-8, IL-15, IL-1β, MCP 1, and VEGF levels, total lymphocyte counts, and CD8+ CD38+ mean fluorescence intensity (MFI), and lower NK-NKG2A MFI and percentage of CD8+ CD38+ T cells. Significant correlations between cytokine and immune cell expression were observed in both groups. Five variables best predicted progression to severe COVID-19 in patients with obesity: diabetes, the EGF, IL-10, and IL-13 levels, and the percentage of CD8+ HLA-DR+ CD38+ cells. Three variables were predictive for patients without obesity: myocardial injury and the percentages of B lymphocytes and HLA-DR+ CD38+ cells. Conclusion: Our findings suggest that clinical and immune variables and obesity interact synergistically to increase the COVID-19 progression risk. The immune signatures of hypertensive patients with and without obesity severe COVID-19 highlight differences in immune dysregulation mechanisms, with potential therapeutic applications.
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