Temporal changes in complement activation in haemodialysis patients with COVID-19 as a predictor of disease progression
Author(s)
Type
Journal Article
Abstract
Background: Complement activation may play a pathogenic role in patients with severe coronavirus disease 2019 (COVID-19) by contributing to tissue inflammation and microvascular thrombosis. Methods: Serial samples were collected from patients receiving maintenance haemodialysis (HD). Thirty-nine patients had confirmed COVID-19 and 10 patients had no evidence of COVID-19. Plasma C5a and C3a levels were measured using enzyme-linked immunosorbent assay. Results: We identified elevated levels of plasma C3a and C5a in HD patients with severe COVID-19 compared with controls. Serial sampling identified that C5a levels were elevated prior to clinical deterioration in patients who developed severe disease. C3a more closely mirrored both clinical and biochemical disease severity. Conclusions: Our findings suggest that activation of complement plays a role in the pathogenesis of COVID-19, leading to endothelial injury and lung damage. C5a may be an earlier biomarker of disease severity than conventional parameters such as C-reactive protein and this warrants further investigation in dedicated biomarker studies. Our data support the testing of complement inhibition as a therapeutic strategy for patients with severe COVID-19.
Date Issued
2020-10-02
Date Acceptance
2020-08-27
ISSN
2048-8505
Publisher
European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
Start Page
889
End Page
896
Journal / Book Title
Clinical Kidney Journal
Volume
13
Issue
5
Copyright Statement
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor
Community Jameel Imperial College COVID-19 Excellence Fund
United Kingdom Research and Innovation
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33123364
sfaa192
Grant Number
MR/S004068/1
Subjects
COVID-19
complement
haemodialysis
COVID-19
complement
haemodialysis
Publication Status
Published
Coverage Spatial
England