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Impact of the immune profiles of hypertensive patients with and without obesity on COVID-19 severityMoll-Bernardes, Renata; Ferreira, Juliana R; Sousa, Andréa Silvestre; Tortelly, Mariana B; Pimentel, Adriana L; Figueiredo, Ana Cristina B S; Schaustz, Eduardo B; Secco, José Carlos Pizzolante; Sales, Allan Robson Kluser; Terzi, Flavia V O; Xavier de Brito, Adriana; Sarmento, Renée O; Noya-Rabelo, Marcia M; Fortier, Sergio; Matos E Silva, Flavia A; Vera, Narendra; Conde, Luciana; Cabral-Castro, Mauro Jorge; Albuquerque, Denilson C; Rosado de-Castro, Paulo; Camargo, Gabriel C; Pinheiro, Martha V T; Souza, Olga F; Bozza, Fernando A; Luiz, Ronir R; Medei, Emiliano
International Journal of Obesity, 02/2024, Volume: 48, Issue: 2Journal Article
Comorbidities such as obesity, hypertension, and diabetes are associated with COVID-19 development and severity, probably due to immune dysregulation; however, the mechanisms underlying these associations are not clear. The immune signatures of hypertensive patients with obesity with COVID-19 may provide new insight into the mechanisms of immune dysregulation and progression to severe disease in these patients. Hypertensive patients were selected prospectively from a multicenter registry of adults hospitalized with COVID-19 and stratified according to obesity (BMI ≥ 30 kg/m²). Clinical data including baseline characteristics, complications, treatment, and 46 immune markers were compared between groups. Logistic regression was performed to identify variables associated with the risk of COVID-19 progression in each group. The sample comprised 213 patients (89 with and 124 without obesity). The clinical profiles of patients with and without obesity differed, suggesting potential interactions with COVID-19 severity. Relative to patients without obesity, patients with obesity were younger and fewer had cardiac disease and myocardial injury. Patients with obesity had higher EGF, GCSF, GMCSF, interleukin (IL)-1ra, IL-5, IL-7, IL-8, IL-15, IL-1β, MCP 1, and VEGF levels, total lymphocyte counts, and CD8 CD38 mean fluorescence intensity (MFI), and lower NK-NKG2A MFI and percentage of CD8 CD38 T cells. Significant correlations between cytokine and immune cell expression were observed in both groups. Five variables best predicted progression to severe COVID-19 in patients with obesity: diabetes, the EGF, IL-10, and IL-13 levels, and the percentage of CD8 HLA-DR CD38 cells. Three variables were predictive for patients without obesity: myocardial injury and the percentages of B lymphocytes and HLA-DR CD38 cells. Our findings suggest that clinical and immune variables and obesity interact synergistically to increase the COVID-19 progression risk. The immune signatures of hypertensive patients with and without obesity severe COVID-19 highlight differences in immune dysregulation mechanisms, with potential therapeutic applications.
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