ArticleJCI insight2022
Atypical response to bacterial coinfection and persistent neutrophilic bronchoalveolar inflammation distinguish critical COVID-19 from influenza.
Article in JCI insight, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed, 61 citations in OpenAlex.
- Comparative innate immune responses across major RNA and DNA viral infections: Mechanisms, immunopathology, and therapeutic perspectives.Human vaccines & immunotherapeutics · 2026Review
- Single-cell profiling reveals epithelial and immune responses in BK polyomavirus-infected human kidney biopsies.JCI insight · 2026Article
- Characteristics and Outcomes of Patients With Hematologic Malignancies Hospitalized With Respiratory Viral Infections.Open forum infectious diseases · 2026Article
- Immunophenotyping of bronchoalveolar lavage and functional impairment in post-COVID syndrome : Insights from a prospective cohort trial.Wiener klinische Wochenschrift · 2025Observational
- Seasonal PMParticle and fibre toxicology · 2025Article
- Neutrophil gene expression in COVID-19 patients with acute respiratory distress syndrome.Frontiers in immunology · 2025Article
- Dual threat: Susceptibility mechanisms and treatment strategies for COVID-19 and bacterial co-infections.Computational and structural biotechnology journal · 2025Review
- TLR2 Activation as a Marker of Severe COVID-19 and a Potential Therapeutic Target.Current medicinal chemistry · 2025Review
- Research trends and hotspots on global influenza and inflammatory response based on bibliometrics.Virology journal · 2024Review
- Heterogeneous neutrophils in lung transplantation and proteolytic CXCL8 activation in COVID-19, influenza and lung transplant patient lungs.Cellular and molecular life sciences : CMLS · 2024Article
- Aprotinin (I): Understanding the Role of Host Proteases in COVID-19 and the Importance of Pharmacologically Regulating Their Function.International journal of molecular sciences · 2024Review
- A narrative review of chemokine receptors CXCR1 and CXCR2 and their role in acute respiratory distress syndrome.European respiratory review : an official journal of the European Respiratory Society · 2024Review
- Novel high-yield potato protease inhibitor panels block a wide array of proteases involved in viral infection and crucial tissue damage.Journal of molecular medicine (Berlin, Germany) · 2024Article
- Risk factors, outcomes, and epidemiological and etiological study of hospitalized COVID-19 patients with bacterial co-infection and secondary infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Association Between Artificial Intelligence Based Chest Computed Tomography and Clinical/Laboratory Characteristics with Severity and Mortality in COVID-19 Hospitalized Patients.Journal of inflammation research · 2024Article
- Curcumin as an antiviral agent and immune-inflammatory modulator in COVID-19: A scientometric analysis.Heliyon · 2023Article
- The Association of Endothelin-1 with Early and Long-Term Mortality in COVID-19.Journal of personalized medicine · 2023Article
- Proteolytic inactivation of CXCL12 in the lungs and circulation of COVID-19 patients.Cellular and molecular life sciences : CMLS · 2023Article
- C5aR1 signaling triggers lung immunopathology in COVID-19 through neutrophil extracellular traps.The Journal of clinical investigation · 2023Article
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Authors and funding
21 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neutrophils are recognized as important circulating effector cells in the pathophysiology of severe coronavirus disease 2019 (COVID-19). However, their role within the inflamed lungs is incompletely understood. Here, we collected bronchoalveolar lavage (BAL) fluids and parallel blood samples of critically ill COVID-19 patients requiring invasive mechanical ventilation and compared BAL fluid parameters with those of mechanically ventilated patients with influenza, as a non-COVID-19 viral pneumonia cohort. Compared with those of patients with influenza, BAL fluids of patients with COVID-19 contained increased numbers of hyperactivated degranulating neutrophils and elevated concentrations of the cytokines IL-1β, IL-1RA, IL-17A, TNF-α, and G-CSF; the chemokines CCL7, CXCL1, CXCL8, CXCL11, and CXCL12α; and the protease inhibitors elafin, secretory leukocyte protease inhibitor, and tissue inhibitor of metalloproteinases 1. In contrast, α-1 antitrypsin levels and net proteolytic activity were comparable in COVID-19 and influenza BAL fluids. During antibiotic treatment for bacterial coinfections, increased BAL fluid levels of several activating and chemotactic factors for monocytes, lymphocytes, and NK cells were detected in patients with COVID-19 whereas concentrations tended to decrease in patients with influenza, highlighting the persistent immunological response to coinfections in COVID-19. Finally, the high proteolytic activity in COVID-19 lungs suggests considering protease inhibitors as a treatment option.
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Registered trials
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