A score combining early detection of cytokines accurately predicts COVID-19 severity and intensive care unit transfer

Nagant, Carole; Ponthieux, Fanny; Smet, Julie; Dauby, Nicolás; Doyen, Virginie; Besse‐Hammer, Tatiana; Bels, David De; Maillart, Evelyne; Corazza, Francis

doi:10.1016/j.ijid.2020.10.003

Cited by 54 publications

(62 citation statements)

References 8 publications

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“…In our models we considered a large array of continuous variables in different domains, including D-dimer and P/F ratio which reflect the more characteristic physiopathological features of COVID-19 pneumonia(14,15,41) and are associated with worst prognosis (42), but discarded some potentially relevant categorical variables as gender, obesity and co-morbidities (43,44) which however are more closely linked with mortality than ICU admission. Moreover the recently described ABO blood-group system and genetic susceptibility loci (45) and some continuous variables as serum Interleukin-6 (23,46), ferritin and procalcitonin (16) were not available. Finally, we did not evaluate death as an outcome due to the small samples.However this would imply to consider treatments and other variables and was beyond the scope of the present investigation.…”

Section: Discussionmentioning

confidence: 99%

The incremental value of computed tomography of COVID-19 pneumonia in predicting ICU admission

Bartolucci

Benelli

Betti

et al. 2021

Preprint

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RationaleTriage is crucial for patient’s management and estimation of the required Intensive Care Unit (ICU) beds is fundamental for Health Systems during the COVID-19 pandemic.ObjectiveTo assess whether chest Computed Tomography (CT) of COVID-19 pneumonia has an incremental role in predicting patient’s admission to ICU.MethodsWe performed volumetric and texture analysis of the areas of the affected lung in CT of 115 outpatients with COVID-19 infection presenting to the Emergency Room with dyspnea and unresponsive hypoxyemia. Admission blood laboratory including lymphocyte count, serum lactate dehydrogenase, D-dimer and C-Reactive Protein and the ratio between the arterial partial pressure of oxygen and inspired oxygen were collected. By calculating the areas under the receiver-operating characteristic curves (AUC), we compared the performance of blood laboratory-arterial gas analyses features alone and combined with the CT features in two hybrid models (Hybrid radiological and Hybrid radiomics)for predicting ICU admission. Following a machine learning approach, 63 patients were allocated to the training and 52 to the validation set.Measurements and Main ResultsTwenty-nine (25%) of patients were admitted to ICU. The Hybrid radiological model comprising the lung %consolidation performed significantly (p=0.04) better in predicting ICU admission in the validation (AUC=0.82; 95%Confidence Interval 0.68-0.95) set than the blood laboratory-arterial gas analyses features alone (AUC=0.71; 95%Confidence Interval 0.56-0.86). A risk calculator for ICU admission was derived and is available at:https://github.com/cgplab/covidappConclusionsThe volume of the consolidated lung in CT of patients with COVID-19 pneumonia has a mild but significant incremental value in predicting ICU admission.

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Section: Discussionmentioning

confidence: 99%

The incremental value of computed tomography of COVID-19 pneumonia in predicting ICU admission

Bartolucci

Benelli

Betti

et al. 2021

Preprint

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“…The predicting biomarkers are important for clinical decision-making; thus many efforts have been made to identify them in patients with COVID-19 pneumonia. Previously, the in ammatory biomarkers (IL-6, IL-8, IL-10 and ratio of IL-6 to IL-10), patients' characteristics (age) and chest CT images (consolidation, emphysema and residual healthy lung parenchyma) have been reported to predict the prognosis of COVID-19 patients [8,32]. In addition, the novel method of machine learning is also used to precisely evaluate the COVID-19 pneumonia [33].…”

Section: Discussionmentioning

confidence: 99%

The predicting roles of carcinoembryonic antigen and its underlying mechanism in the progression of coronavirus disease 2019

Huang

Meng

Zha

et al. 2020

Preprint

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Background The coronavirus disease 2019 (COVID-19) has induced a worldwide pneumonia with a high infectivity and mortality. However, the predicting biomarkers and their potential mechanism in the progression of COVID-19 are not well known. Objective The aim of this study is to identify the candidate predictors of COVID-19 and investigate their underlying mechanism. Methods The retrospective study was conducted to identify the potential laboratory indicators with prognostic values of COVID-19 disease. Then, the prognostic nomogram was constructed to predict the overall survival of COVID-19 patients. Additionally, the scRNA-seq data of BALF and PBMCs from COVID-19 patients were downloaded to investigate the underlying mechanism of the most important prognostic indicators in lungs and peripherals, respectively. Results 304 hospitalized adult COVID-19 patients in Wuhan Jinyintan Hospital were included in the retrospective study. CEA was the only laboratory indicator with significant difference in the univariate (P < 0.001) and multivariate analysis (P = 0.021). The scRNA-seq data of BALF and PBMCs from COVID-19 patients were downloaded to investigate the underlying mechanism of CEA in lungs and peripherals, respectively. The results revealed the potential roles of CEA were significantly distributed in Type II pneumocytes of BALF and developing neutrophils of PBMCs, participating in the progression of COVID-19 by regulating the cell-cell communication. Conclusion This study identifies the prognostic roles of CEA in COVID-19 patients and implies the potential roles of CEACAM8-CEACAM6 in the progression of COVID-19 by regulating the cell-cell communication of developing neutrophils and Type II pneumocyte.

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“…However, cytokines that suppress inflammation (IL-4 and IL-10) have also been observed by increased T-helper-2 secretion [ 5 ]. Some scores have been evaluated that relate levels of cytokines with severity and outcome of SARS-CoV-2 infection, especially IL-6 and IL-10 [ 10 , 138 ]. Therefore, immunomodulatory agents have been proposed as a treatment for COVID-19-associated ARDS.…”

Section: Pharmacological Management Of Covid-19mentioning

confidence: 99%

Pharmacological considerations for the treatment of COVID-19 in people living with HIV (PLWH)

Gutierrez

Mur

Mateo

et al. 2021

Expert Opinion on Pharmacotherapy

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Introduction When coronavirus infectious disease-2019 (COVID-19) blew up, ill-fated auguries on the collision between COVID-19 and the human immunodeficiency virus (HIV) epidemics loomed. Areas covered Data from observational studies suggest similar incidence attacks of SARS-CoV-2 infection in people living with HIV (PLWH) and HIV-uninfected populations. The mortality rate of COVID-19 is similar in both populations too. The authors discuss the role of combination antiretroviral therapy (cART) in preventing infection or reducing COVID-19 severity. They also discuss the pharmacological interventions for COVID-19 in PLWH. Expert opinion Management of COVID-19 in PLWH is no different from the general population. It should be based on careful supportive care, emphasizing lung-protective ventilation, and wise pharmacological interventions. The antiviral drug remdesivir and dexamethasone are the only pharmacological interventions with clinical benefit for COVID-19, whereas anticoagulation may prevent thrombotic complications. The experience with using these drugs in PLWH is limited, which prevents from rendering well-founded conclusions. Until more data on COVID-19 in PLWH become available, the best weapons within our reach are sound supportive care and sensible use of RDV and dexamethasone, bearing in mind the potential for drug–drug interactions of most corticosteroids and antiretroviral drugs.

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A score combining early detection of cytokines accurately predicts COVID-19 severity and intensive care unit transfer

Cited by 54 publications

References 8 publications

The incremental value of computed tomography of COVID-19 pneumonia in predicting ICU admission

The incremental value of computed tomography of COVID-19 pneumonia in predicting ICU admission

The predicting roles of carcinoembryonic antigen and its underlying mechanism in the progression of coronavirus disease 2019

Pharmacological considerations for the treatment of COVID-19 in people living with HIV (PLWH)

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