open access publication

Preprint, 2024

Immunological predictors of disease severity in patients with COVID-19 infection

Authorea, 10.22541/au.170665687.74525854/v1

Contributors

Balushi, Asma Al 0000-0002-9836-4368 [1] Shekaili, Jalila Al [2] Kindi, Mahmood Al [2] Ansari, Zainab [3] Khabori, Murtadha Al [2] Khamis, Faryal Ali [3] Ambusaidi, Zaiyana [3] Balushi, Afra Al [3] Huraizi, Aisha Al [3] Sulaimi, Sumaiya Al [3] Fahdi, Fatma Al [3] Balushi, Iman Al [2] Pandak, Nenad 0000-0002-4379-6219 [3] Fletcher, Tom E 0000-0002-3712-415X [4] Petersen, Eskild 0000-0001-8510-0614 [5] Nasr, Iman H 0000-0003-0346-9675 [3]

Affiliations

  1. [1] Sohar Hospital
    2. [NORA names: Oman; Asia, Middle East];
  2. [2] Sultan Qaboos University Hospital
    3. [NORA names: Oman; Asia, Middle East];
  3. [3] The Royal Hospital
  4. [4] Royal Liverpool University Hospital
    5. [NORA names: United Kingdom; Europe, Non-EU; OECD];
  5. [5] Aarhus University Hospital
    6. [NORA names: Central Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD]

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.

Keywords

C-reactive protein, CD14+CD16, CD14+CD16+, CD4, CD4 T cells, COVID-19, COVID-19 disease progression, COVID-19 infection, COVID-19 patients, D-dimer, ICU, ICU admission, Oman, T cells, admission, analysis, care, cells, coagulopathy, cohort study, comorbid conditions, conditions, critical care, death, dehydrogenase, diabetes, disease progression, disease severity, disseminated intravascular coagulopathy, early predictor, ferritin, fibrinogen, frequency, hospital, hospitalized patients, immune cells, immunological predictors, infection, inflammatory markers, inflammatory monocytes, interleukin-6, intravascular coagulopathy, lactate, lactate dehydrogenase, levels, levels of interleukin-6, markers, monocytes, multivariate regression analysis, naive CD4, naive CD4 T cells, neutrophil/lymphocyte, neutrophil/lymphocyte ratio, non-hospitalized, observational cohort study, outcomes, patients, poor outcome, predictors, predictors of disease severity, predictors of poor outcome, progression, prospective observational cohort study, protein, ratio, regression analysis, resources, severity, statistically, study, tertiary hospital

Data Provider: Digital Science

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