Related Experiment Video
Updated: Dec 8, 2025
Author Spotlight: Advancing Immune Monitoring in Critical Care Patients Using Whole Blood Assays
Published on: September 20, 2024
Complex Immunometabolic Profiling Reveals the Activation of Cellular Immunity and Biliary Lesions in Patients with
Adam Klocperk1, Marketa Bloomfield1,2, Zuzana Parackova1
1Department of Immunology, 2nd Faculty of Medicine, Charles University and University Hospital in Motol, 150 06 Prague, Czech Republic.
Insights
Key laboratory markers in COVID-19 patients reveal disease severity. Severe cases show inflammation and liver issues, while fatal cases exhibit immune dysregulation and kidney failure, impacting disease progression.
Area of Science:
- Immunology
- Pathophysiology
- Clinical Laboratory Science
Background:
- Coronavirus disease 2019 (COVID-19) presents with diverse clinical courses.
- Understanding laboratory markers is crucial for predicting COVID-19 patient outcomes.
- Longitudinal studies are needed to elucidate COVID-19 pathophysiology.
Purpose of the Study:
- To identify laboratory features associated with mild, moderate, severe, and fatal COVID-19.
- To analyze the dynamic changes in laboratory markers during COVID-19 infection.
- To correlate specific laboratory findings with disease severity and organ involvement.
Main Methods:
- Retrospective analysis of laboratory data from hospitalized COVID-19 patients.
- Inclusion of patients admitted between March and June 2020.
- Longitudinal follow-up to track disease progression and laboratory marker dynamics.
Main Results:
- Severe COVID-19 associated with elevated proinflammatory markers, immature granulocytes, CD8 T cell activation, and transient liver disease.
- Elevated serum gamma-glutamyl transferase (GGT) and cholestasis were specific to severe COVID-19.
- Fatal COVID-19 cases showed suppressed inflammation, immune discoordination, and acute kidney failure.
- COVID-19 involves multi-organ effects, activating innate and adaptive immunity.
- Biliary lesions, elevated GGT, and IL-6 producing cells indicate fulminant disease.
Conclusions:
- Laboratory markers can predict COVID-19 severity and patient prognosis.
- Immune response dysregulation and organ-specific damage (liver, kidney) are key in severe/fatal COVID-19.
- Elevated GGT and biliary lesions are hallmarks of severe COVID-19, suggesting specific therapeutic targets.
Abstract:
This study aimed to assess the key laboratory features displayed by coronavirus disease 2019 (COVID-19) inpatients that are associated with mild, moderate, severe, and fatal courses of the disease, and through a longitudinal follow-up, to understand the dynamics of the COVID-19 pathophysiology. All severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients admitted to the University Hospital in Motol between March and June 2020 were included in this study. A severe course of COVID-19 was associated with an elevation of proinflammatory markers; an efflux of immature granulocytes into peripheral blood; the activation of CD8 T cells, which infiltrated the lungs; transient liver disease. In particular, the elevation of serum gamma-glutamyl transferase (GGT) and histological signs of cholestasis were highly specific for patients with a severe form of the disease. In contrast, patients with a fatal course of COVID-19 failed to upregulate markers of inflammation, showed discoordination of the immune response, and progressed toward acute kidney failure. COVID-19 is a disease with a multi-organ affinity that is characterized by the activation of innate and cellular adaptive immunity. Biliary lesions with an elevation of GGT and the organ infiltration of interleukin 6 (IL-6)-producing cells are the defining characteristics for patients with the fulminant disease.
