Immunological predictors of disease severity in patients with COVID-19

Abstract

Background : Identifying immune cells involved in COVID-19 disease progression and predictors of poor outcomes is important to manage patients adequately. Methods : A prospective observational cohort study enrolled 53 mild non-hospitalized and 48 hospitalized confirmed COVID-19 patients to a tertiary hospital in Oman. Results : Hospitalized patients were older (58 years vs 36 years, p <0.001) and had more comorbid conditions like diabetes (65 % Vs 21% p <0.001). Hospitalized patients had significantly higher inflammatory markers ( p <0.001); C-reactive protein (CRP) (114 vs 4 mg/L), Interleukin-6 (IL-6) (33 vs 3.71pg/ml), lactate dehydrogenase (LDH) (417 vs 214 U/L), ferritin (760 vs 196 ng/mL), fibrinogen (6 vs 3 g/L), D-dimer (1.0 vs 0.3 mcg/mL), disseminated intravascular coagulopathy (DIC) score (2 vs 0) and neutrophil/lymphocyte ratio (4 vs 1.1), ( p <0.001). In multivariate regression analysis, statistically significant independent early predictors of ICU admission or death were higher levels of IL-6 (OR 1.03, p =0.03), frequency of large inflammatory monocytes (CD14+CD16+) (OR 1.117, p =0.010) and frequency of circulating naïve CD4+ T cells (CD27+CD28+CD45RA+CCR7+) (OR 0.476, p =0.03). Conclusion : IL-6, frequency of large inflammatory monocytes, and circulating naïve CD4 T cells can be used as independent immunological predictors of poor outcomes in COVID-19 patients to prioritize critical care and resources.

The Association between TNF-α, IL-6, and Vitamin D Levels and COVID-19 Severity and Mortality: A Systematic Review and Meta-Analysis

“…The mean IL-6 levels were recorded to be significantly higher in patients with severe COVID-19 compared with non-severe COVID-19 patients [15,16,[88][89][90][91][92][93][94]. Additionally, IL-6 was also reported as an independent predictor of ICU admission [95]. The results of this meta-analysis were also in line with a previous meta-analysis of RCTs that presented a reduction in the incidence of intubation in COVID-19 patients receiving IL-6 inhibitors [96].…”

Can torque teno virus be a predictor of SARS-CoV-2 disease progression in cancer patients?

“…In addition, earlier studies have shown that in hospitalised patients, inflammatory biomarkers such as C-reactive protein and D-dimer can be used to predict clinical outcomes in COVID-19 patients. [ 29 , 30 ] In this study, we did not find an association between TTV load and these two serological markers.…”

Routine laboratory parameters, including complete blood count, predict COVID-19 in-hospital mortality in geriatric patients

“…Indeed, the identification of laboratory predictors capable of discriminating disease severity and mortality risk will improve clinical awareness, guide interventional studies, and optimize the allocation of human and technical resources in the in-hospital management of COVID-19 ( Henry et al, 2020 ). Previous reports analyzed the routine laboratory biomarkers at hospital admission for COVID-19, suggesting that the most severe forms of COVID-19 were associated with peripheral lymphocyte and neutrophil subsets alteration ( Al Balushi et al, 2021 , Cai et al, 2021b , Lu et al, 2021 , Reusch et al, 2021 , Wang et al, 2020 ). Similarly, a wide range of metabolic parameters and biomarkers of damage, inflammatory responses, and coagulation system activation have been associated with COVID-19 poor outcomes ( Charoenngam et al, 2021 , Heer et al, 2021 , Khamis et al, 2021 , Kitakata et al, 2021 , Lv et al, 2020 , Manocha et al, 2021 , Nurlu et al, 2021 , Tang et al, 2021 )…”