Longitudinal monitoring of laboratory markers characterizes hospitalized and ambulatory COVID-19 patients

Velavan, Thirumalaisamy P.; Kuk, Salih; Linh, Le Thi Kieu; Calle, Carlos Lamsfus; Lalremruata, Albert; Pallerla, Srinivas Reddy; Kreidenweiss, Andrea; Held, Jana; Esen, Meral; Gabor, Julian; Neurohr, Eva Maria; Shamsrizi, Parichehr; Fathi, Anahita; Biecker, Erwin; Berg, Christoph P.; Ramharter, Michael; Addo, Marylyn M.; Kreuels, Benno; Kremsner, Peter G.

doi:10.1038/s41598-021-93950-x

Cited by 17 publications

(17 citation statements)

References 39 publications

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“…A longitudinal study showed that levels of inflammatory cytokines remained elevated in severe COVID-19 cases but declined within days in patients with moderate disease [ 39 ]. The cytokine IL-6 was shown to be a valuable biomarker of COVID-19 severity and an indicator of viral load [ 40 , 41 ].…”

Section: The Immunology Of Sars-cov-2 Infectionmentioning

confidence: 99%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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Since its outbreak in December 2019, the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to an enormous rise in scientific response with an excess of COVID-19-related studies on the pathogenesis and potential therapeutic approaches. Solid organ transplant (SOT) recipients are a heterogeneous population with long-lasting immunosuppression as a joining element. Immunocompromised patients are a vulnerable population with a high risk of severe infections and an increased infection-related mortality rate. It was postulated that the hyperinflammatory state due to cytokine release syndrome during severe COVID-19 could be alleviated by immunosuppressive therapy in SOT patients. On the other hand, it was previously established that T cell-mediated immunity, which is significantly weakened in SOT recipients, is the main component of antiviral immune responses. In this paper, we present the current state of science on COVID-19 immunology in relation to solid organ transplantation with prospective therapeutic and vaccination strategies in this population.

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Section: The Immunology Of Sars-cov-2 Infectionmentioning

confidence: 99%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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“…We found that plasma levels of CHI3L1 were reduced in COVID-19 survivors four weeks after clinical remission, at a time when systemic inflammation had returned to baseline levels 25 . Interestingly, CHI3L1 levels at this point were still significantly higher than in healthy subjects, suggesting that stimuli sustaining CHI3L1 production are still present.…”

Section: Discussionmentioning

confidence: 69%

Chitinase-3-like protein-1 at hospital admission predicts COVID-19 outcome: a prospective cohort study

Cirillo

2022

Sci Rep

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Infectious and inflammatory stimuli elicit the generation of chitinase-3-like protein-1 (CHI3L1), involved in tissue damage, repair and remodeling. We evaluated whether plasma CHI3L1 at disease onset predicts clinical outcome of patients with Coronavirus 2019 (COVID-19) disease. Blood from 191 prospectively followed COVID-19 patients were collected at hospital admission between March 18th and May 5th, 2020. Plasma from 80 survivors was collected one month post-discharge. Forty age- and sex-matched healthy volunteers served as controls. Primary outcome was transfer to intensive care unit (ICU) or death. CHI3L1 was higher in COVID-19 patients than controls (p < 0.0001). Patients with unfavorable outcome (41 patients admitted to ICU, 47 died) had significantly higher CHI3L1 levels than non-ICU survivors (p < 0.0001). CHI3L1 levels abated in survivors one month post-discharge, regardless of initial disease severity (p < 0.0001), although remaining higher than controls (p < 0.05). Cox regression analysis revealed that CHI3L1 levels predict primary outcome independently of age, sex, comorbidities, degree of respiratory insufficiency and systemic inflammation or time from symptom onset to sampling (p < 0.0001). Kaplan–Meier curve analysis confirmed that patients with CHI3L1 levels above the median (361 ng/mL) had a poorer prognosis (log rank test, p < 0.0001). Plasma CHI3L1 is increased in COVID-19 patients and predicts adverse outcome.

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“…To the best our knowledge, so far neither longitudinal data on troponin changes for (out)patients with non-severe COVID-19 have been reported; nor have reports included longitudinal observations for more than 1 year in comparison to a control cohort ( 6 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…Recent evidence suggests that increased troponin levels in patients with severe ( 1 ) COVID-19 are associated with an increased likelihood of cardiovascular disease, critical illness ( 2 , 3 ), and death ( 4 , 5 ). Patients with COVID-19 not only show troponin levels above the 99th percentile more frequently, but also show measurably increased levels of troponins (below the 99th percentile but above the limit of detection) more frequently ( 6 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

Mild COVID-19 induces early, quantifiable, persistent troponin I elevations in elder men

Bürgi¹,

Rösslein²,

Nolte³

et al. 2022

Front. Cardiovasc. Med.

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ImportanceElderly patients, especially men, are at risk of increased morbidity from coronavirus disease 2019 (COVID-19). Long-term data on troponin I levels in longitudinal observational studies of outpatients with mild to moderate COVID-19 are scarce.ObjectiveThis controlled cohort study aimed to evaluate the course of troponin I concentrations over a long period in convalescent COVID-19 outpatients with mild to moderate symptoms.Setting and participantsIn this cohort study, individuals with PCR-confirmed, mild to moderate SARS-CoV-2 infection as well as control individuals with confirmed negative PCR and negative SARS-CoV-2 serology were included. Study visits were performed from April 2020 through July 2021 (initialized during the first wave of the corona pandemic in Switzerland). A study visit in patients comprised blood draws every week in the first month and additionally after 8 weeks. This course was repeated in patients observed long-term.ResultsThis study enrolled 278 individuals from the Canton of St. Gallen, Switzerland, aged 12–92 years (59.5% women), who had mild to moderate COVID-19 symptoms (outpatients only) and a diagnosis confirmed by positive RT-PCR. Fifty-four of the participants with confirmed SARS-CoV-2 infection were followed for 14 months with repeat cycles of the testing protocol. In addition, 115 symptomatic patients that were PCR and serology negative were enrolled in the same time period as a control group. In COVID-19 patients, low-level troponin I concentrations (cTnI) were significantly increased from baseline until week 9 after positive RT-PCR diagnosis in men older than 54 years [ΔcTnI = 5.0 ng/L (median); 95% CI 4.1–6.0; p = 0.02]. The troponin I concentration remained elevated throughout 14 months in men older than 54 years within the cohort with a prolonged observation period. This statistically significant change in troponin I concentration was not dependent on co-morbidities in this group. ALT, Creatinine, BNP, and D-Dimer values after convalescence did not differ in comparison to the control cohort.ConclusionIn this analysis of individuals with confirmed SARS-CoV-2 infection, hs troponin I levels of men aged 54 or older significantly increased after infection. They remained elevated for at least 14 months after diagnosis. This suggests the possibility of an ongoing, long-term, low-grade myocardial injury. Further studies with focus on elderly patients and a prolonged observational period are necessary to elucidate whether the phenomenon observed is associated with detectable structural changes to the heart muscle or is without further clinical consequences.

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Longitudinal monitoring of laboratory markers characterizes hospitalized and ambulatory COVID-19 patients

Cited by 17 publications

References 39 publications

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Chitinase-3-like protein-1 at hospital admission predicts COVID-19 outcome: a prospective cohort study

Mild COVID-19 induces early, quantifiable, persistent troponin I elevations in elder men

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