Stroke-induced Changes to Immune Function and Their Relevance to Increased Risk of Severe COVID-19 Disease

Overview

Journal Discov Immunol

Specialty Allergy & Immunology

Date 2024 Apr 3

PMID 38566903

Authors

Laura McCulloch

Isobel C Mouat

Kieron South

Barry W McColl

Stuart M Allan

Craig J Smith

Affiliations

Soon will be listed here.

Abstract

As the COVID-19 pandemic moves towards endemic disease, it remains of key importance to identify groups of individuals vulnerable to severe infection and understand the biological factors that mediate this risk. Stroke patients are at increased risk of developing severe COVID-19, likely due to stroke-induced alterations to systemic immune function. Furthermore, immune responses associated with severe COVID-19 in patients without a history of stroke parallel many of the immune alterations induced by stroke, possibly resulting in a compounding effect that contributes to worsened disease severity. In this review, we discuss the changes to systemic immune function that likely contribute to augmented COVID-19 severity in patients with a history of stroke and the effects of COVID-19 on the immune system that may exacerbate these effects.

References

Ruggiero A, Piubelli C, Calciano L, Accordini S, Valenti M, Dalle Carbonare L . SARS-CoV-2 vaccination elicits unconventional IgM specific responses in naïve and previously COVID-19-infected individuals. EBioMedicine. 2022; 77:103888. PMC: 8858081. DOI: 10.1016/j.ebiom.2022.103888. View

Lux D, Alakbarzade V, Bridge L, Clark C, Clarke B, Zhang L . The association of neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio with 3-month clinical outcome after mechanical thrombectomy following stroke. J Neuroinflammation. 2020; 17(1):60. PMC: 7026966. DOI: 10.1186/s12974-020-01739-y. View

Molnar T, Papp V, Banati M, Szereday L, Pusch G, Szapary L . Relationship between C-reactive protein and early activation of leukocytes indicated by leukocyte antisedimentation rate (LAR) in patients with acute cerebrovascular events. Clin Hemorheol Microcirc. 2010; 44(3):183-92. DOI: 10.3233/CH-2010-1273. View

Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y . Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clin Infect Dis. 2020; 71(16):2027-2034. PMC: 7184337. DOI: 10.1093/cid/ciaa344. View

Katsoularis I, Fonseca-Rodriguez O, Farrington P, Lindmark K, Fors Connolly A . Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study. Lancet. 2021; 398(10300):599-607. PMC: 8321431. DOI: 10.1016/S0140-6736(21)00896-5. View

Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H . Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020; 130(5):2620-2629. PMC: 7190990. DOI: 10.1172/JCI137244. View

Li G, Wang X, Huang L, Wang Y, Hao J, Ge X . Cytotoxic function of CD8+ T lymphocytes isolated from patients with acute severe cerebral infarction: an assessment of stroke-induced immunosuppression. BMC Immunol. 2013; 14:1. PMC: 3554531. DOI: 10.1186/1471-2172-14-1. View

Smith C, Emsley H, Gavin C, Georgiou R, Vail A, Barberan E . Peak plasma interleukin-6 and other peripheral markers of inflammation in the first week of ischaemic stroke correlate with brain infarct volume, stroke severity and long-term outcome. BMC Neurol. 2004; 4:2. PMC: 331413. DOI: 10.1186/1471-2377-4-2. View

Hernandez-Jimenez E, Gutierrez-Fernandez M, Cubillos-Zapata C, Otero-Ortega L, Rodriguez-Frutos B, Toledano V . Circulating Monocytes Exhibit an Endotoxin Tolerance Status after Acute Ischemic Stroke: Mitochondrial DNA as a Putative Explanation for Poststroke Infections. J Immunol. 2017; 198(5):2038-2046. DOI: 10.4049/jimmunol.1601594. View

10.

Wang E, Mao T, Klein J, Dai Y, Huck J, Jaycox J . Diverse functional autoantibodies in patients with COVID-19. Nature. 2021; 595(7866):283-288. DOI: 10.1038/s41586-021-03631-y. View

11.

Harrington W, Trakhimets O, Andrade D, Dambrauskas N, Raappana A, Jiang Y . Rapid decline of neutralizing antibodies is associated with decay of IgM in adults recovered from mild COVID-19. Cell Rep Med. 2021; 2(4):100253. PMC: 8020863. DOI: 10.1016/j.xcrm.2021.100253. View

12.

Ross A, Hurn P, Perrin N, Wood L, Carlini W, Potempa K . Evidence of the peripheral inflammatory response in patients with transient ischemic attack. J Stroke Cerebrovasc Dis. 2007; 16(5):203-7. PMC: 2570354. DOI: 10.1016/j.jstrokecerebrovasdis.2007.05.002. View

13.

Chamorro A, Amaro S, Vargas M, Obach V, Cervera A, Torres F . Interleukin 10, monocytes and increased risk of early infection in ischaemic stroke. J Neurol Neurosurg Psychiatry. 2006; 77(11):1279-81. PMC: 2077369. DOI: 10.1136/jnnp.2006.100800. View

14.

Deng Q, Yang H, Yan F, Wang H, Xing F, Zuo L . Blocking Sympathetic Nervous System Reverses Partially Stroke-Induced Immunosuppression but does not Aggravate Functional Outcome After Experimental Stroke in Rats. Neurochem Res. 2016; 41(8):1877-86. DOI: 10.1007/s11064-016-1899-8. View

15.

Gendron A, Teitelbaum J, Cossette C, Nuara S, Dumont M, Geadah D . Temporal effects of left versus right middle cerebral artery occlusion on spleen lymphocyte subsets and mitogenic response in Wistar rats. Brain Res. 2002; 955(1-2):85-97. DOI: 10.1016/s0006-8993(02)03368-1. View

16.

Taquet M, Geddes J, Husain M, Luciano S, Harrison P . 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021; 8(5):416-427. PMC: 8023694. DOI: 10.1016/S2215-0366(21)00084-5. View

17.

Mukerji S, Das S, Alabsi H, Brenner L, Jain A, Magdamo C . Prolonged Intubation in Patients With Prior Cerebrovascular Disease and COVID-19. Front Neurol. 2021; 12:642912. PMC: 8062773. DOI: 10.3389/fneur.2021.642912. View

18.

Meisel C, Meisel A . Suppressing immunosuppression after stroke. N Engl J Med. 2011; 365(22):2134-6. DOI: 10.1056/NEJMcibr1112454. View

19.

Urra X, Cervera A, Villamor N, Planas A, Chamorro A . Harms and benefits of lymphocyte subpopulations in patients with acute stroke. Neuroscience. 2008; 158(3):1174-83. DOI: 10.1016/j.neuroscience.2008.06.014. View

20.

Lagunas-Rangel F . Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. J Med Virol. 2020; 92(10):1733-1734. PMC: 7228336. DOI: 10.1002/jmv.25819. View