Low Levels of Granulocytic Myeloid-Derived Suppressor Cells May Be a Good Marker of Survival in the Follow-Up of Patients With Severe COVID-19.
Carlos Jiménez-Cortegana, Flora Sánchez-Jiménez, Antonio Pérez-Pérez, Nerissa Álvarez, Alberto Sousa, Luisa Cantón-Bulnes, Teresa Vilariño-García, Sandra Fuentes, Salomón Martín, Marta Jiménez, Antonio León-Justel, Luis de la Cruz-Merino, José Garnacho-Montero, Víctor Sánchez-Margalet
Author Information
Carlos Jiménez-Cortegana: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Flora Sánchez-Jiménez: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Antonio Pérez-Pérez: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Nerissa Álvarez: Intensive Care Unit, Virgen Macarena University Hospital, Seville, Spain.
Alberto Sousa: Intensive Care Unit, Virgen Macarena University Hospital, Seville, Spain.
Luisa Cantón-Bulnes: Intensive Care Unit, Virgen Macarena University Hospital, Seville, Spain.
Teresa Vilariño-García: Department of Medical Biochemistry and Molecular Biology, School of Medicine, University of Seville, Seville, Spain.
Sandra Fuentes: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Salomón Martín: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Marta Jiménez: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Antonio León-Justel: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Luis de la Cruz-Merino: Medical Oncology Service, Virgen Macarena University Hospital, Seville, Spain.
José Garnacho-Montero: Intensive Care Unit, Virgen Macarena University Hospital, Seville, Spain.
Víctor Sánchez-Margalet: Department of Laboratory Medicine, Virgen Macarena University Hospital, Seville, Spain.
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a disease (coronavirus disease 2019, COVID-19) that may develop into a systemic disease with immunosuppression and death in its severe form. Myeloid-derived suppressive cells (MDSCs) are inhibitory cells that contribute to immunosuppression in patients with cancer and infection. Increased levels of MDSCs have been found in COVID-19 patients, although their role in the pathogenesis of severe COVID-19 has not been clarified. For this reason, we raised the question whether MDSCs could be useful in the follow-up of patients with severe COVID-19 in the intensive care unit (ICU). Thus, we monitored the immunological cells, including MDSCs, in 80 patients admitted into the ICU. After 1, 2, and 3 weeks, we examined for a possible association with mortality (40 patients). Although the basal levels of circulating MDSCs did not discriminate between the two groups of patients, the last measurement before the endpoint (death or ICU discharge) showed that patients discharged alive from the ICU had lower levels of granulocytic MDSCs (G-MDSCs), higher levels of activated lymphocytes, and lower levels of exhausted lymphocytes compared with patients who had a bad evolution (death). In conclusion, a steady increase of G-MDSCs during the follow-up of patients with severe COVID-19 was found in those who eventually died.
