Respiratory infection with the SARS-CoV2 virus is associated with a major risk of viral pneumonia that can lead to respiratory distress requiring resuscitation. In the most severe forms, it may require a mechanical ventilation or even lead to an acute respiratory distress syndrome with a particularly poor prognosis. The SARS-CoV2 is a single-stranded RNA virus of positive polarity and belongs to the beta genus of Coronaviruses. SARS-CoV2 is responsible for the third epidemic in less than twenty years secondary to a Coronavirus (SARS-CoV then MERS-CoV) and if the mortality associated with it is lower than that of previous strains, particularly MERS-CoV (Middle East Respiratory Syndrome), its spread is considerably bigger. As a result, the number of patients developing respiratory distress that require an invasive mechanical ventilation is high, with prolonged ventilation duration in these situations.
The mechanisms responsible for alveolar damage during viral pathologies, particularly
Coronavirus, are very similar to those observed during acute respiratory distress syndromes
in adults. Macrophages present in the pulmonary parenchyma appear to play a central role in
the severity of the inflammatory response and the production of proinflammatory mediators,
notably chemokines leading to secondary leukocyte infiltration. The recent monocytic origin
could explain the particular severity of this inflammatory response whose usual control is no
longer assured. The alteration of infectious control by alveolar macrophages during ageing
also tends to confirm the central role of these cells in the pattern of respiratory distress
observed during COVID-19 infection, which is particularly severe in the elderly.
In many situations, the endotoxin (or lipopolysaccharide, LPS) plays a major role in the
pathophysiology and even the severity of respiratory damage, in particular, due to the
existence of circulating endotoxin from the pathogenic agent responsible (Gram-negative
bacteria), but also due to translocation of digestive origin in the context of sepsis
(systemic inflammatory response) which is associated with (if not responsible for)
respiratory aggression. Such an alteration of the mucous membrane is particularly noticeable
in cases of obesity. The importance of this mechanism during pulmonary aggression of viral
origin is, on the other hand, unknown.
Few data are available on the prediction of early onset of respiratory distress syndrome in
low respiratory infection in the absence of mechanical ventilation.
Other: Blood samples
A blood sample will be collected on a dry tube with 5mL separating gel on each enrolled patients. Those will be made depending on the patients hospitalization.
Inclusion Criteria:
- Patient aged from 18 years old
- French-speaking patient
- Patient whose COVID-19 respiratory infection was confirmed by laboratory tests (either
by a PCR and any other commercial or public health tests) or a scanner, that requires
a hospitalization in a healthcare institution.
Exclusion Criteria:
- Patient/ relative or proxy person opposed to the study participation
- Patient under guardianship or curators
- Patient deprived of liberty
- Patient under the safeguard of justice.
- Dying / Moribund patient
- Pregnant or breastfeeding woman
Groupe Hospitalier Paris Saint-Joseph
Paris, Ile De France, France
Centre Hospitalier Victor Dupouy
Argenteuil, France
François PHILIPPART, MD, Principal Investigator
Groupe Hospitalier Paris Saint Joseph