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Zacharias, M; Kashofer, K; Wurm, P; Regitnig, P; Schütte, M; Neger, M; Ehmann, S; Marsh, LM; Kwapiszewska, G; Loibner, M; Birnhuber, A; Leitner, E; Thüringer, A; Winter, E; Sauer, S; Pollheimer, MJ; Vagena, FR; Lackner, C; Jelusic, B; Ogilvie, L; Durdevic, M; Timmermann, B; Lehrach, H; Zatloukal, K; Gorkiewicz, G.
Host and microbiome features of secondary infections in lethal covid-19.
iScience. 2022; 25(9):104926
Doi: 10.1016/j.isci.2022.104926
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- Führende Autor*innen der Med Uni Graz
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Gorkiewicz Gregor
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Kashofer Karl
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Zacharias Martin
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Zatloukal Kurt
- Co-Autor*innen der Med Uni Graz
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Anthofer Margit
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Birnhuber Anna
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Durdevic Marija
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Kapo Barbara
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Kwapiszewska-Marsh Grazyna
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Lackner Karoline
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Leitner-Meyer Eva
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Loibner Martina
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Marsh Leigh
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Pollheimer Marion
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Regitnig Peter
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Sauer Stefan
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Vagena Fotini Rosi
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Winter Elke
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Wurm Philipp
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- Abstract:
- Secondary infections contribute significantly to covid-19 mortality but driving factors remain poorly understood. Autopsies of 20 covid-19 cases and 14 controls from the first pandemic wave complemented with microbial cultivation and RNA-seq from lung tissues enabled description of major organ pathologies and specification of secondary infections. Lethal covid-19 segregated into two main death causes with either dominant diffuse alveolar damage (DAD) or secondary pneumonias. The lung microbiome in covid-19 showed a reduced biodiversity and increased prototypical bacterial and fungal pathogens in cases of secondary pneumonias. RNA-seq distinctly mirrored death causes and stratified DAD cases into subgroups with differing cellular compositions identifying myeloid cells, macrophages and complement C1q as strong separating factors suggesting a pathophysiological link. Together with a prominent induction of inhibitory immune-checkpoints our study highlights profound alterations of the lung immunity in covid-19 wherein a reduced antimicrobial defense likely drives development of secondary infections on top of SARS-CoV-2 infection.