The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients
IntroductionCOVID-19 severity and high in-hospital mortality are often associated with severe hypoxemia, hyperlactatemia, and acidosis, yet the key players driving this association remain unclear. It is generally assumed that organ damage causes toxic acidosis, but since neutrophil numbers in severe...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmolb.2024.1510592/full |
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| author | Basma A. Yasseen Aya A. Elkhodiry Hajar El-sayed Mona Zidan Azza G. Kamel Mohamed A. Badawy Marwa S. Hamza Riem M. El-Messiery Mohamed El Ansary Engy A. Abdel-Rahman Engy A. Abdel-Rahman Sameh S. Ali |
| author_facet | Basma A. Yasseen Aya A. Elkhodiry Hajar El-sayed Mona Zidan Azza G. Kamel Mohamed A. Badawy Marwa S. Hamza Riem M. El-Messiery Mohamed El Ansary Engy A. Abdel-Rahman Engy A. Abdel-Rahman Sameh S. Ali |
| author_sort | Basma A. Yasseen |
| collection | DOAJ |
| description | IntroductionCOVID-19 severity and high in-hospital mortality are often associated with severe hypoxemia, hyperlactatemia, and acidosis, yet the key players driving this association remain unclear. It is generally assumed that organ damage causes toxic acidosis, but since neutrophil numbers in severe COVID-19 can exceed 80% of the total circulating leukocytes, we asked if metabolic acidosis mediated by the glycolytic neutrophils is associated with lung damage and impaired oxygen delivery in critically ill patients.MethodsBased on prospective mortality outcome, critically ill COVID-19 patients were divided into ICU- survivors and ICU-non-survivors. Samples were analyzed to explore if correlations exist between neutrophil counts, lung damage, glycolysis, blood lactate, blood pH, hemoglobin oxygen saturation, and mortality outcome. We also interrogated isolated neutrophils, platelets, and PBMCs for glycolytic activities.ResultsArterial blood gas analyses showed remarkable hypoxemia in non-survivors with no consistent differences in PCO2 or [HCO3−]. The hemoglobin oxygen dissociation curve revealed a right-shift, consistent with lower blood-pH and elevated blood lactate in non-survivors. Metabolic analysis of different blood cells revealed increased glycolytic activity only when considering the total number of neutrophils.ConclusionThis indicates the role of neutrophilia in hyperlactatemia and lung damage, subsequently contributing to mortality outcomes in severe SARS-CoV-2 infection. |
| format | Article |
| id | doaj-art-efbc913d83c5473095f3db8c77c93f84 |
| institution | Kabale University |
| issn | 2296-889X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Molecular Biosciences |
| spelling | doaj-art-efbc913d83c5473095f3db8c77c93f842025-01-06T05:13:16ZengFrontiers Media S.A.Frontiers in Molecular Biosciences2296-889X2025-01-011110.3389/fmolb.2024.15105921510592The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patientsBasma A. Yasseen0Aya A. Elkhodiry1Hajar El-sayed2Mona Zidan3Azza G. Kamel4Mohamed A. Badawy5Marwa S. Hamza6Riem M. El-Messiery7Mohamed El Ansary8Engy A. Abdel-Rahman9Engy A. Abdel-Rahman10Sameh S. Ali11Research Department, Children’s Cancer Hospital Egypt, Cairo, EgyptResearch Department, Children’s Cancer Hospital Egypt, Cairo, EgyptResearch Department, Children’s Cancer Hospital Egypt, Cairo, EgyptResearch Department, Children’s Cancer Hospital Egypt, Cairo, EgyptResearch Department, Children’s Cancer Hospital Egypt, Cairo, EgyptResearch Department, Children’s Cancer Hospital Egypt, Cairo, EgyptDepartment of Clinical Pharmacy Practice, Faculty of Pharmacy, The British University in Egypt, Cairo, EgyptInfectious Disease Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, EgyptDepartment of Intensive Care, Faculty of Medicine, Cairo University, Cairo, EgyptResearch Department, Children’s Cancer Hospital Egypt, Cairo, EgyptPharmacology Department, Faculty of Medicine, Assuit University, Assuit, EgyptResearch Department, Children’s Cancer Hospital Egypt, Cairo, EgyptIntroductionCOVID-19 severity and high in-hospital mortality are often associated with severe hypoxemia, hyperlactatemia, and acidosis, yet the key players driving this association remain unclear. It is generally assumed that organ damage causes toxic acidosis, but since neutrophil numbers in severe COVID-19 can exceed 80% of the total circulating leukocytes, we asked if metabolic acidosis mediated by the glycolytic neutrophils is associated with lung damage and impaired oxygen delivery in critically ill patients.MethodsBased on prospective mortality outcome, critically ill COVID-19 patients were divided into ICU- survivors and ICU-non-survivors. Samples were analyzed to explore if correlations exist between neutrophil counts, lung damage, glycolysis, blood lactate, blood pH, hemoglobin oxygen saturation, and mortality outcome. We also interrogated isolated neutrophils, platelets, and PBMCs for glycolytic activities.ResultsArterial blood gas analyses showed remarkable hypoxemia in non-survivors with no consistent differences in PCO2 or [HCO3−]. The hemoglobin oxygen dissociation curve revealed a right-shift, consistent with lower blood-pH and elevated blood lactate in non-survivors. Metabolic analysis of different blood cells revealed increased glycolytic activity only when considering the total number of neutrophils.ConclusionThis indicates the role of neutrophilia in hyperlactatemia and lung damage, subsequently contributing to mortality outcomes in severe SARS-CoV-2 infection.https://www.frontiersin.org/articles/10.3389/fmolb.2024.1510592/fulllung damageCOVID-19 mortalityneutrophilslactateacidosis |
| spellingShingle | Basma A. Yasseen Aya A. Elkhodiry Hajar El-sayed Mona Zidan Azza G. Kamel Mohamed A. Badawy Marwa S. Hamza Riem M. El-Messiery Mohamed El Ansary Engy A. Abdel-Rahman Engy A. Abdel-Rahman Sameh S. Ali The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients Frontiers in Molecular Biosciences lung damage COVID-19 mortality neutrophils lactate acidosis |
| title | The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients |
| title_full | The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients |
| title_fullStr | The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients |
| title_full_unstemmed | The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients |
| title_short | The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients |
| title_sort | role of neutrophilia in hyperlactatemia blood acidosis impaired oxygen transport and mortality outcome in critically ill covid 19 patients |
| topic | lung damage COVID-19 mortality neutrophils lactate acidosis |
| url | https://www.frontiersin.org/articles/10.3389/fmolb.2024.1510592/full |
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