Tissue-resident macrophages require specific milieus for the maintenance of defining gene-expression programs. Expression of the transcription factor GATA6 is required for the homeostasis, function and localization of peritoneal cavity-resident macrophages. Gata6 expression is maintained in a non-cell autonomous manner and is elicited by the vitamin A metabolite, retinoic acid. Here, we found that the GATA6 transcriptional program is a common feature of macrophages residing in all visceral body cavities. Retinoic acid-dependent and -independent hallmark genes of GATA6 + macrophages were induced by mesothelial and fibroblastic stromal cells that express the transcription factor Wilms' Tumor 1 (WT1), which drives the expression of two rate-limiting enzymes in retinol metabolism. Depletion of Wt1 + stromal cells reduced the frequency of GATA6 + macrophages in the peritoneal, pleural and pericardial cavities. Thus, Wt1 + mesothelial and fibroblastic stromal cells constitute essential niche components supporting the tissue-specifying transcriptional landscape and homeostasis of cavity-resident macrophages.
Background
Coronavirus disease 2019 (COVID‐19) is a global pandemic and information on risk factors for worse prognosis is needed to accurately identify patients at risk and potentially provide insight into therapeutic options.
Methods
In this retrospective cohort study, including 3703 patients with laboratory confirmed COVID‐19, we identified risk factors associated with all‐cause mortality, need for hospitalization and mechanical ventilation.
Results
Male gender was independently associated with increased risk of hospitalization (Adjusted Odds Ratio (OR
adj
: 1.62 (95% Confidence Interval (95% CI): 1.38‐ 1.91)), mechanical ventilation (OR
adj
: 1.35 (95% CI: 1.08‐ 1.69)) and death (OR
adj
: 1.46 (95% CI: 1.17‐ 1.82)). Patients > 60 years had higher risk of hospitalization (OR
adj
: 5.47 (95% CI: 4.29‐ 6.96)), mechanical ventilation (OR
adj
: 3.26 (95% CI: 2.08‐ 5.11)) and death (OR
adj
: 13.04 (95% CI: 6.25‐ 27.24)). Congestive heart failure (OR
adj
: 1.47 (95% CI: 1.06‐ 2.02)) and dementia (OR
adj
: 2.03 (95% CI: 1.46‐ 2.83)) were associated with increased odds of death, as well as the presence of more than two comorbidities (OR
adj
: 1.90 (95% CI: 1.35‐ 2.68)).
Conclusion
COVID‐19 patients of older age, male gender or having more than two comorbidities are at higher risk of hospitalization, mechanical ventilation and death, and should therefore be closely monitored.
This article is protected by copyright. All rights reserved.
Coronavirus diseases (COVID-19) is associated with high rates of morbidity and mortality and worse outcomes have been reported for various morbidities. The impact of pre-existing hypothyroidism on COVID-19 outcomes remains unknown. The aim of the present study was to identify a possible association between hypothyroidism and outcomes related to COVID-19 including hospitalization, need for mechanical ventilation, and all-cause mortality. All patients with a laboratory confirmed COVID-19 diagnosis in March 2020 in a large New York City health system were reviewed. Of the 3703 COVID-19 positive patients included in present study, 251 patients (6.8%) had pre-existing hypothyroidism and received thyroid hormone therapy. Hypothyroidism was not associated with increased risk of hospitalization [Adjusted Odds Ratio (OR adj): 1.23 (95% Confidence Interval (CI): 0.88-1.70)], mechanical ventilation [OR adj : 1.17 (95% CI: 0.81-1.69)] nor death [OR adj : 1.07 (95% CI: 0.75-1.54)]. This study provides insight into the role of hypothyroidism on the outcomes of COVID-19 positive patients, indicating that no additional precautions or consultations are needed. However, future research into the potential complications of COVID-19 on the thyroid gland and function is warranted.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.