Biomarkers for Prognosis and Treatment Response in COVID-19 Patients

Bivona, Giulia; Agnello, Luisa; Ciaccio, Marcello

doi:10.3343/alm.2021.41.6.540

Cited by 111 publications

(141 citation statements)

References 83 publications

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“…The interplay between innate and adaptive immune responses is involved in the development of COVID-19 disease. In fact, COVID-19 has an inflammatory pathophysiology involving a cytokine storm and it has been reported that during this infection the level of various analytes can change [ 15 ]. The unpredictability of the clinical course of the disease reinforces the need to find biomarkers that can help identify patients who are more vulnerable to clinical deterioration and improve patients’ management [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Toward finding the difference between untreated celiac disease and COVID-19 infected patients in terms of CD4, CD25 (IL-2 Rα), FOXP3 and IL-6 expressions as genes affecting immune homeostasis

Asri

Nazemalhosseini‐Mojarad

Mirjalali

et al. 2021

BMC Gastroenterol

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Background Coronavirus disease 2019 (COVID-19) is defined as an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 and celiac disease (CD) is one of the autoimmune multiorgan diseases, which can be accompanied by an increased risk of viral infections. CD patients, especially untreated subjects, may be at greater risk of infections such as viral illnesses. Interleukin (IL)-6, CD4, CD25, and FOXP3 are known as genes affecting immune homeostasis and relate to the inflammation state. This study aimed to compare the expression levels of aforementioned genes in peripheral blood samples of CD and severe COVID-19 patients. Methods Sixty newly diagnosed CD patients with median age (mean ± SD) of 35.40 ± 24.12 years; thirty confirmed severe COVID-19 patients with median age (mean ± SD) of 59.67 ± 17.22, and 60 healthy subjects with median age (mean ± SD) of 35.6 ± 13.02 years; were recruited from March to September 2020. Fresh whole blood samples were collected, total RNA was obtained and cDNA synthesis was carried out. RNA expression levels of IL-6, CD4, CD25, and FOXP3 genes were assessed using real-time quantitative RT-PCR according to the 2−∆∆Ct formula. Statistical analysis was performed using SPSS (V.21) and GraphPad, Prism (V.6). Results While increased expression of CD4, CD25, and FOXP3 was observed in CD patients compared to the control group (p = 0.02, p = 0.03, and p < 0.0001 respectively) and COVID-19 patients group (p < 0.0001 for all of them), their expression levels in COVID-19 patients decreased compared to controls (p < 0.0001, p = 0.01, p = 0.007, respectively). Increased IL-6 expression was observed in both groups of patients compared to controls (p < 0.0001 for both of them). Conclusions Although untreated CD patients may be at greater risk of developing into severe COVID-19 if they are infected by SARS-CoV-2 virus (due to their high expression of IL-6), increased expression of anti-inflammatory markers in these patients may be beneficial for them with the ability of reducing the severity of COVID-19 disease, which needs to be proven in future studies involving celiac patients infected with COVID-19.

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Section: Introductionmentioning

confidence: 99%

“…Previous studies investigated different biomarkers such as C-reactive protein (CRP), interleukin (IL)-6, procalcitonin (PCT), etc. in COVID-19 patients and their association with disease progression [ 15 ]. Among them IL-6 has attracted particular attention.…”

Section: Introductionmentioning

confidence: 99%

Toward finding the difference between untreated celiac disease and COVID-19 infected patients in terms of CD4, CD25 (IL-2 Rα), FOXP3 and IL-6 expressions as genes affecting immune homeostasis

Asri

Nazemalhosseini‐Mojarad

Mirjalali

et al. 2021

BMC Gastroenterol

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“…Currently, HLH was included in the umbrella term of “hyperferritinemic syndromes” [ 5 ]. Therefore, as suggested by some investigators, HLH is worth drawing attention as a severe complication of COVID-19 [ 11 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Hemophagocytosis, hyper-inflammatory responses, and multiple organ damages in COVID-19-associated hyperferritinemia

Dong

Gao

et al. 2021

Ann Hematol

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Hyperferritinemia comes to light frequently in general practice. However, the characteristics of COVID-19-associated hyperferritinemia and the relationship with the prognosis were not well described. The retrospective study included 268 documented COVID-19 patients. They were divided into the hyperferritinemia group (≥ 500 µg/L) and the non-hyperferritinemia group (< 500 µg/L). The prevalence of fever and thrombocytopenia and the proportion of patients with mechanical ventilator support and in-hospital death were much higher in the hyperferritinemia group (P < 0.001). The hyperferritinemia patients showed higher median IL-6, D-dimer, and hsCRP (P < 0.001) and lowered FIB level (P = 0.036). The hyperferritinemia group had a higher proportion of patients with AKI, ARDS, and CSAC (P < 0.001). According to the multivariate analysis, age, chronic pulmonary disease, and hyperferritinemia were found to be significant independent predictors for in-hospital mortality [HR 1.041 (95% CI 1.015–1.068), P = 0.002; HR 0.427 (95% CI 0.206–0.882), P = 0.022; HR 6.176 (95% CI 2.447–15.587), P < 0.001, respectively]. The AUROC curve was 0.88, with a cut-off value of ≥ 971 µg/L. COVID-19 patients with hyperferritinemia had a high proportion of organ dysfunction, were more likely to show hyper-inflammation, progressed to hemophagocytic lymphohistiocytosis, and indicated a higher proportion of death.

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“…Selection of an appropriate method should be based on the characteristics of the pathogen and patients, the intended purpose of testing, and the laboratory resources available in each region. This issue focuses on papers demonstrating the characteristics of various COVID-19 diagnostic methods [ 5 – 8 ]. The study by Lee, et al .…”

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confidence: 99%

“…Bivona, et al . [ 8 ] review the potential clinical usefulness of various biomarkers. Although studies have shown that some biomarkers, such as C-reactive protein, prothrombin time, and D-dimer, are promising for determining severity, the authors note that more prospective studies are needed to evaluate the usefulness of biomarkers in patient management [ 8 ].…”

mentioning

confidence: 99%