TY - INPR A1 - Recktenwald, Steffen Michael A1 - Simionato, Greta A1 - Lopez, Marcelle Guedes de Medeiros A1 - Gamboni, Fabia A1 - Dzieciatkowska, Monika A1 - Meybohm, Patrick A1 - Zacharowski, Kai A1 - Knethen, Andreas von A1 - Wagner, Christian A1 - Kästner, Lars A1 - D’Alessandro, Angelo A1 - Quint, Stephan T1 - Cross-talk between red blood cells and plasma influences blood flow and omics phenotypes in severe COVID-19 T2 - medRxiv N2 - Coronavirus disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and can affect multiple organs, among which is the circulatory system. Inflammation and mortality risk markers were previously detected in COVID-19 plasma and red blood cells (RBCs) metabolic and proteomic profiles. Additionally, biophysical properties, such as deformability, were found to be changed during the infection. Based on such data, we aim to better characterize RBC functions in COVID-19. We evaluate the flow properties of RBCs in severe COVID-19 patients admitted to the intensive care unit by using in vitro microfluidic techniques and automated methods, including artificial neural networks, for an unbiased RBC analysis. We find strong flow and RBC shape impairment in COVID-19 samples and demonstrate that such changes are reversible upon suspension of COVID-19 RBCs in healthy plasma. Vice versa, healthy RBCs immediately resemble COVID-19 RBCs when suspended in COVID-19 plasma. Proteomics and metabolomics analyses allow us to detect the effect of plasma exchanges on both plasma and RBCs and demonstrate a new role of RBCs in maintaining plasma equilibria at the expense of their flow properties. Our findings provide a framework for further investigations of clinical relevance for therapies against COVID-19 and possibly other infectious diseases. Y1 - 2022 UR - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/85521 UR - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-855218 UR - https://www.medrxiv.org/content/10.1101/2022.03.31.22273226v1 IS - 2022.03.31.22273226 Version 1 PB - medRxiv ER -