Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetes

Abstract Early in the COVID‐19 pandemic, type 2 diabetes (T2D) was marked as a risk factor for severe disease and mortality. Inflammation is central to the aetiology of both conditions where variations in immune responses can mitigate or aggravate disease course. Identifying at‐risk groups based on...

Full description

Saved in:
Bibliographic Details
Main Authors: Fawaz Alzaid, Jean‐Baptiste Julla, Marc Diedisheim, Charline Potier, Louis Potier, Gilberto Velho, Bénédicte Gaborit, Philippe Manivet, Stéphane Germain, Tiphaine Vidal‐Trecan, Ronan Roussel, Jean‐Pierre Riveline, Elise Dalmas, Nicolas Venteclef, Jean‐François Gautier
Format: Article
Language:English
Published: Springer Nature 2020-09-01
Series:EMBO Molecular Medicine
Subjects:
Online Access:https://doi.org/10.15252/emmm.202013038
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849343191583555584
author Fawaz Alzaid
Jean‐Baptiste Julla
Marc Diedisheim
Charline Potier
Louis Potier
Gilberto Velho
Bénédicte Gaborit
Philippe Manivet
Stéphane Germain
Tiphaine Vidal‐Trecan
Ronan Roussel
Jean‐Pierre Riveline
Elise Dalmas
Nicolas Venteclef
Jean‐François Gautier
author_facet Fawaz Alzaid
Jean‐Baptiste Julla
Marc Diedisheim
Charline Potier
Louis Potier
Gilberto Velho
Bénédicte Gaborit
Philippe Manivet
Stéphane Germain
Tiphaine Vidal‐Trecan
Ronan Roussel
Jean‐Pierre Riveline
Elise Dalmas
Nicolas Venteclef
Jean‐François Gautier
author_sort Fawaz Alzaid
collection DOAJ
description Abstract Early in the COVID‐19 pandemic, type 2 diabetes (T2D) was marked as a risk factor for severe disease and mortality. Inflammation is central to the aetiology of both conditions where variations in immune responses can mitigate or aggravate disease course. Identifying at‐risk groups based on immunoinflammatory signatures is valuable in directing personalised care and developing potential targets for precision therapy. This observational study characterised immunophenotypic variation associated with COVID‐19 severity in T2D. Broad‐spectrum immunophenotyping quantified 15 leucocyte populations in peripheral circulation from a cohort of 45 hospitalised COVID‐19 patients with and without T2D. Lymphocytopenia and specific loss of cytotoxic CD8+ lymphocytes were associated with severe COVID‐19 and requirement for intensive care in both non‐diabetic and T2D patients. A morphological anomaly of increased monocyte size and monocytopenia restricted to classical CD14Hi CD16− monocytes was specifically associated with severe COVID‐19 in patients with T2D requiring intensive care. Increased expression of inflammatory markers reminiscent of the type 1 interferon pathway (IL6, IL8, CCL2, INFB1) underlaid the immunophenotype associated with T2D. These immunophenotypic and hyperinflammatory changes may contribute to increased voracity of COVID‐19 in T2D. These findings allow precise identification of T2D patients with severe COVID‐19 as well as provide evidence that the type 1 interferon pathway may be an actionable therapeutic target for future studies.
format Article
id doaj-art-7c72d6f547d64ae5b2a37caae2a48163
institution Kabale University
issn 1757-4676
1757-4684
language English
publishDate 2020-09-01
publisher Springer Nature
record_format Article
series EMBO Molecular Medicine
spelling doaj-art-7c72d6f547d64ae5b2a37caae2a481632025-08-20T03:43:10ZengSpringer NatureEMBO Molecular Medicine1757-46761757-46842020-09-01121011210.15252/emmm.202013038Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetesFawaz Alzaid0Jean‐Baptiste Julla1Marc Diedisheim2Charline Potier3Louis Potier4Gilberto Velho5Bénédicte Gaborit6Philippe Manivet7Stéphane Germain8Tiphaine Vidal‐Trecan9Ronan Roussel10Jean‐Pierre Riveline11Elise Dalmas12Nicolas Venteclef13Jean‐François Gautier14Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisINSERM, INRA, Aix Marseille University, C2VNEndocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de MarseilleCenter for Interdisciplinary Research in Biology (CIRB), College de France – Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research UniversityDepartment of Diabetes, Clinical Investigation Centre (CIC‐9504), Lariboisière Hospital, Assistance Publique – Hôpitaux de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisCordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université, Université de ParisAbstract Early in the COVID‐19 pandemic, type 2 diabetes (T2D) was marked as a risk factor for severe disease and mortality. Inflammation is central to the aetiology of both conditions where variations in immune responses can mitigate or aggravate disease course. Identifying at‐risk groups based on immunoinflammatory signatures is valuable in directing personalised care and developing potential targets for precision therapy. This observational study characterised immunophenotypic variation associated with COVID‐19 severity in T2D. Broad‐spectrum immunophenotyping quantified 15 leucocyte populations in peripheral circulation from a cohort of 45 hospitalised COVID‐19 patients with and without T2D. Lymphocytopenia and specific loss of cytotoxic CD8+ lymphocytes were associated with severe COVID‐19 and requirement for intensive care in both non‐diabetic and T2D patients. A morphological anomaly of increased monocyte size and monocytopenia restricted to classical CD14Hi CD16− monocytes was specifically associated with severe COVID‐19 in patients with T2D requiring intensive care. Increased expression of inflammatory markers reminiscent of the type 1 interferon pathway (IL6, IL8, CCL2, INFB1) underlaid the immunophenotype associated with T2D. These immunophenotypic and hyperinflammatory changes may contribute to increased voracity of COVID‐19 in T2D. These findings allow precise identification of T2D patients with severe COVID‐19 as well as provide evidence that the type 1 interferon pathway may be an actionable therapeutic target for future studies.https://doi.org/10.15252/emmm.202013038COVID‐19inflammationmonocyteSARS‐CoV-2type 2 diabetes
spellingShingle Fawaz Alzaid
Jean‐Baptiste Julla
Marc Diedisheim
Charline Potier
Louis Potier
Gilberto Velho
Bénédicte Gaborit
Philippe Manivet
Stéphane Germain
Tiphaine Vidal‐Trecan
Ronan Roussel
Jean‐Pierre Riveline
Elise Dalmas
Nicolas Venteclef
Jean‐François Gautier
Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetes
EMBO Molecular Medicine
COVID‐19
inflammation
monocyte
SARS‐CoV-2
type 2 diabetes
title Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetes
title_full Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetes
title_fullStr Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetes
title_full_unstemmed Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetes
title_short Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID‐19 in type 2 diabetes
title_sort monocytopenia monocyte morphological anomalies and hyperinflammation characterise severe covid 19 in type 2 diabetes
topic COVID‐19
inflammation
monocyte
SARS‐CoV-2
type 2 diabetes
url https://doi.org/10.15252/emmm.202013038
work_keys_str_mv AT fawazalzaid monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT jeanbaptistejulla monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT marcdiedisheim monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT charlinepotier monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT louispotier monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT gilbertovelho monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT benedictegaborit monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT philippemanivet monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT stephanegermain monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT tiphainevidaltrecan monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT ronanroussel monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT jeanpierreriveline monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT elisedalmas monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT nicolasventeclef monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes
AT jeanfrancoisgautier monocytopeniamonocytemorphologicalanomaliesandhyperinflammationcharacteriseseverecovid19intype2diabetes