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Complement Activation in the Disease Course of Coronavirus Disease 2019 and Its Effects on Clinical Outcomes

Aline H de Nooijer1, Inge Grondman1, Nico A F Janssen1

  • 1Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.

The Journal of Infectious Diseases
|October 10, 2020
PubMed

Insights

The complement system is activated in COVID-19 patients, correlating with disease severity and complications. Complement factors may serve as prognostic markers and therapeutic targets for severe COVID-19.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Excessive immune responses in COVID-19 are linked to severity and mortality.
  • The complement system, part of innate immunity, stimulates inflammation.
  • The role of the complement system in COVID-19 pathogenesis was previously unknown.

Purpose of the Study:

  • To investigate the role of the complement system in COVID-19.
  • To assess complement system activation in hospitalized COVID-19 patients.
  • To explore potential prognostic value and therapeutic targets within the complement system.

Main Methods:

  • Prospective, longitudinal, single-center study.
  • Measured plasma concentrations of complement factors C3a, C3c, and terminal complement complex (TCC).
  • Collected and analyzed routine laboratory and clinical data from hospitalized COVID-19 patients.

Main Results:

  • COVID-19 patients showed significantly increased C3a, C3c, and TCC compared to healthy controls.
  • Complement factors were markedly elevated in intensive care unit patients throughout the disease course.
  • Higher complement activation correlated with increased mortality and thromboembolic events.

Conclusions:

  • COVID-19 patients exhibit complement system activation linked to disease severity.
  • This activation may contribute to the inflammatory response, mortality, and complications.
  • Complement system components show potential as prognostic markers and therapeutic targets for COVID-19.
Abstract

Keywords:
ARDSCOVID-19CoagulationComplementInflammationSARS-CoV-2

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