In-depth analysis of laboratory parameters reveals the interplay between sex, age, and systemic inflammation in individuals with COVID-19

Caten, Felipe Ten; Gonzalez-Dias, Patrícia; Castro, Ícaro Maia Santos de; Ogava, Rodrigo L T; Giddaluru, Jeevan; Silva, Juan Carlo S; Martins, Fernando; Gonçalves, André Nicolau Aquime; Costa-Martins, André G.; Araújo, José Deney Alves; Viegas, Ana Carolina; Cunha, Fernando Q.; Farsky, Sandra; Bozza, Fernando A.; Levin, Anna Sara Shafferman; Pannaraj, Pia S.; Silva, Thushan I. de; Minoprio, Paola; Silva, Fabiano Pinheiro da; Andrade, Bruno B.; Nakaya, Helder I.

doi:10.1016/j.ijid.2021.03.016

Cited by 36 publications

(42 citation statements)

References 29 publications

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“…Other biochemical parameters indicative of pathological inflammatory or procoagulant states, such as elevated IL-6, CRP or D-dimer levels, eventually return to near-physiological levels in both survivors and patients with fatal outcomes. This has been observed in other studies 45,46 , and suggests that the normalization of these factors is insufficient, per se, to abate the pathological hyperinflammation and hypercoagulation accompanying severe COVID-19 with a fatal outcome, which would require the concomitant alleviation of lymphopenia and neutrophilia. On the other hand, although different stimuli and conditions such as mechanical ventilation, muscle immobilization, severe sepsis, and multiple organ dysfunction as well as neuro/myotoxic agents may contribute to a critical status amongst patients admitted to ICU 47 , all severe patients in our study, with either survivor or deceased outcomes, were under comparable pharmacological and physical management (Tables ST1 and ST2).…”

Section: Discussionsupporting

confidence: 55%

Recovery of serum testosterone levels is an accurate predictor of survival from COVID-19 in male patients

Paciucci¹

2021

Preprint

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Infection with SARS-CoV-2 portends a broad range of outcomes, from a majority of asymptomatic cases or mild clinical courses to a lethal disease. Robust correlates of severe COVID-19 include old age, male sex, poverty and co-morbidities such as obesity, diabetes or cardiovascular disease. A precise knowledge is still lacking of the molecular and biological mechanisms that may explain the association of severe disease with male sex. Here, we show that testosterone trajectories are highly accurate individual predictors (AUC of ROC = 0.928, p < 0.0001) of survival in male COVID-19 patients. Longitudinal determinations of blood levels of luteinizing hormone (LH) and androstenedione suggest an early modest inhibition of the central LH-androgen biosynthesis axis in a majority of patients, followed by either full recovery in survivors or a peripheral failure in lethal cases. Moreover, failure to reinstate physiological testosterone levels was associated with evidence of impaired T helper differentiation and decrease of non-classical monocytes. The strong association of recovery or failure to reinstate testosterone levels with survival or death from COVID-19 in male patients is suggestive of a significant role of testosterone status in the immune responses to COVID-19.

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Section: Discussionsupporting

confidence: 55%

Recovery of serum testosterone levels is an accurate predictor of survival from COVID-19 in male patients

Paciucci¹

2021

Preprint

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“…Interestingly, our search demonstrates that both basophils and mast cells are probably involved in the pathogenesis of COVID-19 disease: the former may exert a protective role and the latter may play a key role in the pathogenesis. Indeed, basophil count and/or percentage seems to be reduced in COVID-19 patients as compared to controls [43,45,46,63,64,79], and this is the case in severe COVID-19 disease as compared to mild/moderate disease [49][50][51]. As mentioned in the introduction, basophils can act synergically with dendritic cells as antigen-presenting cells to CD4+ T cells and promote B cell response through induction of Th2 cell differentiation [39,40,[82][83][84][85][86][87].…”

Section: Discussionmentioning

confidence: 96%

“…A multidimensional analysis performed on laboratory parameters and diagnostic test of 178.887 Brazilian individuals, of whom 33.266 resulted in being positive for SARS-CoV 2 [45]. A case-control study [46] involving 74 COVID-19 patients and 228 non-COVID-19 patients, showed a significant reduction of basophil levels in COVID-19 patients, a result more evident in men older than 25 years of age in the Brazilian study.…”

Section: Basophils and Covid-19 Diseasementioning

confidence: 96%

Basophils and Mast Cells in COVID-19 Pathogenesis

Murdaca

Gioacchino

Greco³

et al. 2021

Cells

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Basophils and mast cells are among the principal inducers of Th2 responses and have a crucial role in allergic and anti-parasitic protective immunity. Basophils can function as antigen-presenting cells that bind antigens on their surface and boost humoral immune responses, inducing Th2 cell differentiation. Their depletion results in lower humoral memory activation and greater infection susceptibility. Basophils seem to have an active role upon immune response to SARS-CoV-2. In fact, a coordinate adaptive immune response to SARS-CoV-2 is magnified by basophils. It has been observed that basophil amount is lower during acute disease with respect to the recovery phase and that the grade of this depletion is an important determinant of the antibody response to the virus. Moreover, mast cells, present in a great quantity in the nasal epithelial and lung cells, participate in the first immune response to SARS-CoV-2. Their activation results in a hyperinflammatory syndrome through the release of inflammatory molecules, participating to the “cytokine storm” and, in a longer period, inducing pulmonary fibrosis. The literature data suggest that basophil counts may be a useful prognostic tool for COVID-19, since their reduction is associated with a worse prognosis. Mast cells, on the other hand, represent a possible therapeutic target for reducing the airway inflammation characteristic of the hyperacute phase of the disease.

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“…En esta revisión sistemática hubo una mayor prevalencia de hombres. En cuanto a las alteraciones de laboratorio de COVID-19, las diferencias entre sexos se acentúan a partir de los 13 años, con cambios en los marcadores de función hepática comunes en diferentes grupos de edad, mientras que la elevación de biomarcadores de inflamación se destaca en hombres mayores (43) .…”

Section: Discussionunclassified

Cambios en la función hepática causados por COVID-19 y su impacto en el resultado clínico del paciente: una revisión sistemática

Costa

Lima

Kniess

et al. 2021

Rev. colomb. Gastroenterol.

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Introducción: En marzo de 2020, la Organización Mundial de la Salud (OMS) decretó la pandemia de la enfermedad por coronavirus de 2019 (COVID-19), que consiste en la infección por coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2). Este virus utiliza la enzima convertidora de angiotensina II (ECA-II) como receptor celular humano, que está presente en el tejido pulmonar, cardíaco, gastrointestinal, hepático, renal y vascular, lo que configura un potencial de afectación multisistémica por parte del patógeno. El hígado puede resultar dañado tanto por la liberación excesiva de citocinas inflamatorias en COVID-19 como por la adopción de fármacos con potencial hepatotóxico en el tratamiento de sus síntomas. Objetivo: analizar la relación entre los cambios en la función hepática causados por el SARS-CoV-2 y su impacto en el pronóstico del paciente. Métodos: el presente estudio consiste en una revisión sistemática, realizada a partir de estudios seleccionados de las bases de datos PMC, LILACS y SciELO. Después de aplicar los criterios de inclusión y exclusión, se definieron 30 artículos para componer la base de datos de este estudio. Resultados: La enzima aspartato-aminotransferasa (AST) estaba aumentando en mayor prevalencia, con un total de 4695 casos, mientras que la alanina-aminotransferasa (ALT) estaba elevada en 3226 casos. Se observa que los pacientes que presentaban síntomas digestivos tenían más probabilidades de presentar daño hepatocelular y, en consecuencia, alteraciones enzimáticas. Además, la mortalidad ocurrió en el 28,9 % de los casos de pacientes con función hepática alterada, mientras que, en aquellos con función normal, esta tasa fue del 9 %. Conclusión: es evidente que existe una relación entre la afectación hepática por COVID-19 y su mortalidad. Sin embargo, todavía existe una limitación en la cantidad y, principalmente, en la homogeneidad de los estudios que realizaron dicha valoración.

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In-depth analysis of laboratory parameters reveals the interplay between sex, age, and systemic inflammation in individuals with COVID-19

Cited by 36 publications

References 29 publications

Recovery of serum testosterone levels is an accurate predictor of survival from COVID-19 in male patients

Recovery of serum testosterone levels is an accurate predictor of survival from COVID-19 in male patients

Basophils and Mast Cells in COVID-19 Pathogenesis

Cambios en la función hepática causados por COVID-19 y su impacto en el resultado clínico del paciente: una revisión sistemática

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