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Key patient demographics shape innate immune topography in noncritical hypoxic COVID-19 pneumonia.

ABSTRACT: Risk of severe disease and death due to COVID-19 is increased in certain patient demographic groups, including those of advanced age, male sex, and obese body mass index. Investigations of the biological variations that contribute to this risk have been hampered by heterogeneous severity, with immunologic features of critical disease potentially obscuring differences between risk groups. To examine immune heterogeneity related to demographic risk factors, we enrolled 38 patients hospitalized with clinically homogeneous COVID-19 pneumonia - defined as oxygen saturation less than 94% on room air without respiratory failure, septic shock, or multiple organ dysfunction - and performed single-cell RNA-Seq of leukocytes collected at admission. Examination of individual risk factors identified strong shifts within neutrophil and monocyte/dendritic cell (Mo/DC) compartments, revealing altered immune cell type-specific responses in higher risk COVID-19 patient subgroups. Specifically, we found transcriptional evidence of altered neutrophil maturation in aged versus young patients and enhanced cytokine responses in Mo/DCs of male versus female patients. Such innate immune cell alterations may contribute to outcome differences linked to these risk factors. They also highlight the importance of diverse patient cohorts in studies of therapies targeting the immune response in COVID-19.

SUBMITTER: Billi AC

PROVIDER: S-EPMC10543737 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Key patient demographics shape innate immune topography in noncritical hypoxic COVID-19 pneumonia.

Billi Allison C AC Wasikowski Rachael R Ma Feiyang F Yalavarthi Srilakshmi S Hoy Claire K CK Zuo Yu Y Patrick Matthew T MT Shah Neha N Parker Christine C Aaronson Chad C Harbaugh Alyssa A Lucido Matthew F MF Shedden Kerby K Rao Krishna K IglayReger Heidi B HB Burant Charles F CF Kahlenberg J Michelle JM Tsoi Lam C LC Gudjonsson Johann E JE Knight Jason S JS Kanthi Yogendra Y

JCI insight 20230822 16

Risk of severe disease and death due to COVID-19 is increased in certain patient demographic groups, including those of advanced age, male sex, and obese body mass index. Investigations of the biological variations that contribute to this risk have been hampered by heterogeneous severity, with immunologic features of critical disease potentially obscuring differences between risk groups. To examine immune heterogeneity related to demographic risk factors, we enrolled 38 patients hospitalized wit ...[more]

PMID: 37606044

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Project description:BackgroundA multi-dimensional telemedicine patient satisfaction measure is utilized to provide managerial insights into where service improvements are needed and factors that impact patient service perceptions. This research explores the influence of patient demographics on telemedicine satisfaction. Four dimensions of telemedicine patient satisfaction (health benefits, patient-centered care, monetary costs, and non-monetary costs) were compared across patient gender, income, and education levels.MethodsA survey of 440 US telemedicine patients on patient satisfaction was measured with Likert scale items to create a multi-dimensional construct using the SERVQUAL model. MANOVA, ANOVA, and linear contrasts were used to examine the impact of patient demographics on telemedicine satisfaction dimensions.ResultsThe findings revealed that patient demographic characteristics moderated various dimensions of their telemedicine experience satisfaction. Satisfaction with telemedicine health benefits was moderated by patient gender and income levels. Patient-centered care was moderated by patient gender, income, and education levels. Satisfaction with the monetary cost of telemedicine was associated with patient gender and education level. Patient education level influenced their satisfaction with telemedicine non-monetary costs.DiscussionNotable trends include generally higher patient satisfaction for women and those with lower education levels. Patient income showed mixed trends regarding the four dimensions of patient satisfaction. Improvements in patient health literacy along with customized services may improve telemedicine patient care satisfaction and health outcomes.ConclusionsMeasuring telemedicine patient satisfaction with a multi-dimensional assessment tool provides insights into how patient demographics influence perceptions of services received. The findings highlighted perceptions of telemedicine patient satisfaction dimensions that differed across patient demographics and provided insights into their overall impact on telemedicine patient satisfaction.

Dataset Information

Key patient demographics shape innate immune topography in noncritical hypoxic COVID-19 pneumonia.

Publications

Key patient demographics shape innate immune topography in noncritical hypoxic COVID-19 pneumonia.

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