“Acute” monoclonal gammopathy in severe COVID-19

Vazzana, Natale; Ognibene, Silvia; Dipaola, Francesco

doi:10.1016/j.htct.2020.05.002

Cited by 14 publications

(14 citation statements)

References 2 publications

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“…Most of the viral infections causing BFP reactions are associated with polyclonal-gammopathy. Acute monoclonal gammopathy is also reported in COVID-19 5 ; BFP reactions can be attributed to this phenomenon.…”

Section: Post-covid-19 Biologically False-positive Vdrl: a Reportmentioning

confidence: 80%

Letter to the Editor

Ahmed

Ganguly

2022

Int J STD AIDS

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Section: Post-covid-19 Biologically False-positive Vdrl: a Reportmentioning

confidence: 80%

Letter to the Editor

Ahmed

Ganguly

2022

Int J STD AIDS

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“…As a result of multiple immunoglobulin synthesis, polyclonal FLCs overproduction was also observed. On the other hand, it has been suggested that in severe COVID-19 the presence of “acute” monoclonal gammopathy reflects hyperactivation of the immune system [ 32 ]. Moreover, it has been suggested that immunoglobulin G subclass 4 may contribute to the progression of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…This can be explained by the fact that IgG4 has lower SARS-CoV-2 neutralizing titres compared to other IgG subclasses [ 10 , 33 ]. On the contrary, we observed that patients with a mild course of COVID-19 also had increased levels of IgG4 [ 32 ]. Therefore, we carefully suggest that determination of IgG4 concentration may be an important serological biomarker of SARS-CoV-2 infection which can be used for differentiation between COVID-19 and patients without coronavirus infection.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Free Light Chains (FLCs) Synthesis in Response to Exposure to SARS-CoV-2

Gudowska-Sawczuk

Moniuszko

Pączek

et al. 2022

IJMS

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The aim of this study is to assess the synthesis of kappa (κ) and lambda (λ) free light chains (FLCs) in the serum of patients with COVID-19. All the 120 serum samples were collected from patients with COVID-19 and from healthy controls (vaccinated and non-vaccinated against SARS-CoV-2). FLCs, IgG total, IgG4, IgG anti-Nucleocapsid (N), anti-spike S1 receptor binding domain (S-RBD) antibodies and IL-6 were measured according to the manufacturers’ instructions. The concentrations of anti-N IgG, IgG total, IgG4 and IL-6 were elevated in the COVID-19 group in comparison to the vaccinated and non-vaccinated controls. The levels of anti-S-RBD IgG and κFLC were increased in COVID-19 and healthy vaccinated patients when compared to non-vaccinated controls. λFLC concentration was higher in the COVID-19 group than in the non-vaccinated group. The κ:λ ratio was lower in both COVID-19 and non-vaccinated groups in comparison to vaccinated controls. κFLC correlated with all tested parameters (anti-S-RBD IgG, anti-N IgG, λFLC, κ:λ ratio, IgG total, IgG4 and IL-6) except CRP, whereas λFLC correlated with all examined parameters except IgG4. Elevated levels of FLCs in COVID-19 and healthy vaccinated against SARS-CoV-2 patients, as well as the correlation between free light chains with specific anti-SARS-CoV-2 antibodies and IL-6, reflect hyperactivation of the immune system after contact with coronavirus. Furthermore, it seems that serum levels of FLCs might be used as predictive markers of COVID-19. Our findings suggest that free light chains are involved in SARS-CoV-2 infection. However, understanding the exact mechanism requires further investigation.

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“…16 Many acute inflammatory processes, including bacterial and viral infections, can create focussed reactive changes in immunoglobulins which may be initially mistaken for a monoclonal protein, or prevent the confident determination of an absence of a plasma cell dyscrasia. [16][17][18] Certain electrophoresis methods are also subject to interferences from imaging contrast dyes and antibiotics. 19 Ordering these tests in the hospital frequently leads to follow-up testing after the reactive process and acute therapy resolve.…”

Section: Rationalementioning

confidence: 99%

Reduce, Reuse, Recycle: Top 10 Choosing Wisely Canada’s Recommendations for Conserving Laboratory Resources

Beriault

Rodríguez-Capote

Hauff

et al. 2022

Can Journ Gen Int Med

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The COVID-19 pandemic has significantly impacted the production, distribution, and demand of essential laboratory supplies worldwide. In 2021, severe shortages in required laboratory supplies such as blood collection tubes, butterfly needles, and blood gas syringes became a critical issue across Canada. Many hospitals or institutions had to instruct physicians and patients to limit laboratory testing where possible and, in some cases, required emergency shipments of tubes from alternative vendors or nearby hospitals. Laboratory testing is ubiquitous in managing patients. It is used for screening, diagnosis, and monitoring purposes. With limited blood collection tubes, consideration for restricting non-urgent testing is needed to conserve supply and protect acute care departments that manage critically ill patients. In addition, laboratories across Canada have experienced significant staffing shortages, resulting in an even greater need for appropriate laboratory utilization. Consequently, the Canadian Society of Clinical Chemists (CSCC) and the Canadian Association of Medical Biochemists (CAMB) curated utilization recommendations for both hospital and primary care settings in collaboration with Choosing Wisely Canada (CWC). These recommendations were specifically selected from those previously published by Choosing Wisely Canada (CWC), with impact statements and rationales added to conserve at-risk laboratory resources. Supply chain disruptions of clinical laboratory resources are expected to continue throughout 2022, indicating that now, more than ever, a focus on appropriate laboratory utilization is essential. RésuméLa pandémie de COVID-19 a eu un impact considérable sur la production, la distribution et la demande de fournitures de laboratoire essentielles dans le monde entier. À partir de 2021, de graves pénuries de fournitures de laboratoire essentielles, comme les tubes pour prélèvement sanguin, les aiguilles à ailettes et les seringues pour l’analyse de gaz sanguin, sont devenues un question cruciale au Canada. De nombreux hôpitaux et étab-lissements ont dû demander aux médecins et aux patients de limiter dans la mesure du possible les analyses en laboratoire et, dans certains cas, ont eu besoin qu’on leur envoie d’urgence des tubes provenant d’autres fournis-seurs ou d’hôpitaux voisins. Les analyses en laboratoire sont omniprésentes dans la prise en charge des patients et sont utilisées à des fins de dépistage, de diagnostic et de suivi. Étant donné le nombre limité de tubes pour prélèvement sanguin, il faut envisager de restreindre les analyses non urgentes pour conserver les réserves et protéger les services de soins de courte durée qui prennent en charge les patients gravement malades. De plus, partout au Canada, les laboratoires connaissent des pénuries importantes de personnel, ce qui rend encore plus nécessaire une utilisation appropriée des laboratoires. Par conséquent, la Société canadienne des clini-co-chimistes (SCCC) et l’Association des médecins biochimistes du Canada (CAMB), en collaboration avec Choisir avec soin (CAS), ont préparé des recommandations d’utilisation pour les milieux hospitaliers et de soins de santé primaires. Ces recommandations ont été spécifiquement choisies à partir de celles déjà publiées par CAS, en y ajoutant des énoncés des répercussions et des justifications, et visent à conserver les ressources de laboratoire à risque. On s’attend à ce que les perturbations de la chaîne d’approvisionnement en ressources de laboratoire clinique se poursuivent tout au long de l’année 2022, ce qui indique que maintenant, plus que jamais, il est essentiel de se concentrer sur une utilisation appropriée des laboratoires.

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“Acute” monoclonal gammopathy in severe COVID-19

Cited by 14 publications

References 2 publications

Letter to the Editor

Letter to the Editor

Evaluation of Free Light Chains (FLCs) Synthesis in Response to Exposure to SARS-CoV-2

Reduce, Reuse, Recycle: Top 10 Choosing Wisely Canada’s Recommendations for Conserving Laboratory Resources

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