下呼吸道菌群或影响危重症新冠肺炎患者的临床结局
创作:aluba 审核:aluba 2021年11月27日
  • 纳入142名新冠肺炎危重症患者(需要机械通气),通过支气管镜检对下呼吸道菌群进行分析;
  • 院内呼吸道病原体感染与死亡结局无显著关联;
  • 下呼吸道菌群中的唾液支原体(一种口腔共生菌)富集与较差的临床结局(死亡或机械通气28天以上)相关;
  • 下呼吸道菌群的功能(糖苷酶、氧化还原酶等)与临床结局相关;
  • 较高的新冠病毒丰度、较低的新冠病毒抗体应答、独特的宿主下呼吸道转录组(IFN-α、趋化等相关通路的激活)与死亡风险增加相关。
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aluba
Nature Microbiology上发表的一项前瞻性队列研究结果,在142名需要机械通气的新冠肺炎危重症患者中发现,院内呼吸道感染与死亡结局无显著关联,而下呼吸道菌群的组成及功能、新冠病毒丰度、新冠病毒抗体应答、宿主的下呼吸道转录组特征等因素与临床结局相关。
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Nature Microbiology [IF:17.745]

Microbial signatures in the lower airways of mechanically ventilated COVID-19 patients associated with poor clinical outcome

机械通气新冠肺炎患者的下呼吸道菌群特征与较差的临床结局相关

10.1038/s41564-021-00961-5

2021-08-31, Article

Abstract & Authors:展开

Abstract:收起
Respiratory failure is associated with increased mortality in COVID-19 patients. There are no validated lower airway biomarkers to predict clinical outcome. We investigated whether bacterial respiratory infections were associated with poor clinical outcome of COVID-19 in a prospective, observational cohort of 589 critically ill adults, all of whom required mechanical ventilation. For a subset of 142 patients who underwent bronchoscopy, we quantified SARS-CoV-2 viral load, analysed the lower respiratory tract microbiome using metagenomics and metatranscriptomics and profiled the host immune response. Acquisition of a hospital-acquired respiratory pathogen was not associated with fatal outcome. Poor clinical outcome was associated with lower airway enrichment with an oral commensal (Mycoplasma salivarium). Increased SARS-CoV-2 abundance, low anti-SARS-CoV-2 antibody response and a distinct host transcriptome profile of the lower airways were most predictive of mortality. Our data provide evidence that secondary respiratory infections do not drive mortality in COVID-19 and clinical management strategies should prioritize reducing viral replication and maximizing host responses to SARS-CoV-2.

First Authors:
Imran Sulaiman

Correspondence Authors:
Elodie Ghedin,Leopoldo N Segal

All Authors:
Imran Sulaiman,Matthew Chung,Luis Angel,Jun-Chieh J Tsay,Benjamin G Wu,Stephen T Yeung,Kelsey Krolikowski,Yonghua Li,Ralf Duerr,Rosemary Schluger,Sara A Thannickal,Akiko Koide,Samaan Rafeq,Clea Barnett,Radu Postelnicu,Chang Wang,Stephanie Banakis,Lizzette Pérez-Pérez,Guomiao Shen,George Jour,Peter Meyn,Joseph Carpenito,Xiuxiu Liu,Kun Ji,Destiny Collazo,Anthony Labarbiera,Nancy Amoroso,Shari Brosnahan,Vikramjit Mukherjee,David Kaufman,Jan Bakker,Anthony Lubinsky,Deepak Pradhan,Daniel H Sterman,Michael Weiden,Adriana Heguy,Laura Evans,Timothy M Uyeki,Jose C Clemente,Emmie de Wit,Ann Marie Schmidt,Bo Shopsin,Ludovic Desvignes,Chan Wang,Huilin Li,Bin Zhang,Christian V Forst,Shohei Koide,Kenneth A Stapleford,Kamal M Khanna,Elodie Ghedin,Leopoldo N Segal

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Nature Microbiology期刊

Lung microbiota and COVID-19 severity

2021-09-27

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