Journal Article

High rate of HSV-1 reactivation in invasively ventilated COVID-19 patients: Immunological findings

Seeßle, Jessica, Merle, Uta, Gsenger, Julia, Giese, Thomas, Hippchen, Theresa, Schnitzler, Paul

2021

Overview

SARS-CoV-2 infection can lead to severe acute respiratory distress syndrome with the need of invasive ventilation. Pulmonary herpes simplex-1 (HSV-1) reactivation in invasively ventilated patients is a known phenomenon. To date very little is known about the frequency and the predisposing factors of HSV-1 reactivation in COVID-19. Therefore, we evaluated our cohort of invasively ventilated COVID-19 patients with severe pneumonia for HSV-1 in respiratory specimens and combined these results with functional immunomonitoring of the peripheral blood. Tracheal secretions and bronchial lavages were screened by PCR for HSV-1 positivity. Comprehensive immunophenotyping and quantitative gene expression analysis of Interferon-stimulated genes (IFI44L, MX1, RSAD2, ISIG15 and IFIT1) and IL-1 beta were performed in whole blood. Time course of infection beginning at symptom onset was grouped into three phases (“early” phase 1: day 1–10, “middle” phase 2: day 11–30 and “late” phase 3: day 31–40). Pulmonary HSV-1 reactivation was exclusively observed in the later phases 2 and 3 in 15 of 18 analyzed patients. By FACS analysis a significant increase in activated CD8 T cells (CD38 + HLADR + ) in phase 2 was found when compared with phase 1 (p<0.05). Expression of Interferon-stimulated genes (IFI44L, RSAD2 ISIG15, MX1, IFIT1) was significantly lower after HSV-1 detection than before. Taken together, reactivation of HSV-1 in the later phase of SARS-CoV-2- infection occurs in parallel with a drop of antiviral innate responsiveness as shown by decreased expression of Interferon-stimulated genes and a concurrent increase of highly activated CD38 + HLADR + CD8 T cells.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Antibodies / Antiviral drugs / Biology and Life Sciences / Blood / Care and treatment / CD38 antigen / CD8 antigen / Coronaviruses / COVID-19 / Critically ill / Diseases / Flow cytometry / Gastroenterology / Gene expression / Genes / Herpes simplex / Herpes viruses / Histocompatibility antigen HLA / Immunology / Infections / Interferon / Interleukin 1 / Laboratories / Lavage / Lymphocytes / Lymphocytes T / Manufacturers / Mechanical ventilation / Medical imaging / Medicine and Health Sciences / Myxovirus resistance proteins / Pathogens / Peripheral blood / Pneumonia / Relapse / Respiratory distress syndrome / Risk factors / Secretions / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Statistics / Ventilation / Ventilators / Viral infections / Virology