Along with PaO2/FiO2 ratio and lymphopenia, low HLA-DR monocytes are the only additional parameter that independently predicts the clinical course of undifferentiated SARS-CoV-2 patients in emergency departments.

Autor:	Lafon T; Emergency Department, University Hospital Center of Limoges, 2 avenue Martin Luther King, 87042 Limoges, France.; Institut National de la Santé et de la Recherche Médicale Centre d'Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France., Chapuis N; Institut National de la Santé et de la Recherche Médicale U1016, Centre National de la Recherche Scientifique Unité Mixte de Recherche 8104, Institut Cochin, Université Paris Cité, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France.; Service d'Hématologie Biologique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre-Université Paris Cité, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France., Guerin E; Laboratoire d'Hématologie Biologique, Centre Hospitalier Universitaire de Limoges, Centre de Biologie et de Recherche en Santé, rue Bernard Descottes, 87042 Limoges, France., Daix T; Institut National de la Santé et de la Recherche Médicale Centre d'Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France.; Réanimation Polyvalente, Centre Hospitalier Universitaire de Limoges, 2 avenue Martin Luther King, 87042 Limoges, France.; Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1092, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France., Otranto M; Emergency Department, University Hospital Center of Limoges, 2 avenue Martin Luther King, 87042 Limoges, France., Boumediene A; Laboratoire Immunologie, Centre Hospitalier Universitaire de Limoges, Centre de Biologie et de Recherche en Santé, rue Bernard Descottes, 87042 Limoges, France., Jeannet R; Institut National de la Santé et de la Recherche Médicale Centre d'Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France.; Unité Mixte de Recherche Centre National de Recherche Scientifique 7276/Institut National de la Santé et de la Recherche Médicale U1262, Contrôle de la Réponse Immune B et Lymphoproliférations, Centre de Biologie et de Recherche en Santé, rue Bernard Descottes, 87025 Limoges, France., Fontenay M; Institut National de la Santé et de la Recherche Médicale U1016, Centre National de la Recherche Scientifique Unité Mixte de Recherche 8104, Institut Cochin, Université Paris Cité, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France.; Service d'Hématologie Biologique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre-Université Paris Cité, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France., Henri Hani K; Emergency Department, University Hospital Center of Limoges, 2 avenue Martin Luther King, 87042 Limoges, France., Vignon P; Institut National de la Santé et de la Recherche Médicale Centre d'Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France.; Réanimation Polyvalente, Centre Hospitalier Universitaire de Limoges, 2 avenue Martin Luther King, 87042 Limoges, France.; Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1092, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France., Monneret G; Laboratoire d'Immunologie, Hôpital E. Herriot, Hospices Civils de Lyon, 5 Pl. d'Arsonval, 69003 Lyon, France., François B; Institut National de la Santé et de la Recherche Médicale Centre d'Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France.; Réanimation Polyvalente, Centre Hospitalier Universitaire de Limoges, 2 avenue Martin Luther King, 87042 Limoges, France.; Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1092, Centre Hospitalier Universitaire Dupuytren, 2 avenue Martin Luther King, 87042 Limoges, France., Jean-Philippe J; Imagine Institute, Université Paris Cité, 24 Bd du Montparnasse, 75015 Paris, France.; Biostatistic Unit, Necker University Hospital, Assistance Publique-Hôpitaux de Paris, 149 rue de Sèvre, 75015 Paris, France.; Human Genetics of Infectious Diseases: Complex Predisposition, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1163, 24 Bd du Montparnasse, 75015 Paris, France., Feuillard J; Laboratoire d'Hématologie Biologique, Centre Hospitalier Universitaire de Limoges, Centre de Biologie et de Recherche en Santé, rue Bernard Descottes, 87042 Limoges, France.; Unité Mixte de Recherche Centre National de Recherche Scientifique 7276/Institut National de la Santé et de la Recherche Médicale U1262, Contrôle de la Réponse Immune B et Lymphoproliférations, Centre de Biologie et de Recherche en Santé, rue Bernard Descottes, 87025 Limoges, France.
Jazyk:	angličtina
Zdroj:	Journal of leukocyte biology [J Leukoc Biol] 2024 May 29; Vol. 115 (6), pp. 1131-1142.
DOI:	10.1093/jleuko/qiae022
Abstrakt:	Because one-third of patients deteriorate after their admission to the emergency department, assessing the prognosis of COVID-19 patients is of great importance. However, to date, only lymphopenia and the partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio have been reported as partly predictive of COVID-19-related further deterioration, and their association has not been evaluated. We asked whether other key biomarkers of SARS-CoV-2 immunologic defects-increase in circulating immature granulocytes, loss of monocyte HLA-DR (mHLA-DR) expression, and monocyte differentiation blockade-could also predict further COVID-19 deterioration. A series of 284 consecutive COVID-19 patients, with the sole inclusion criterion of being an adult, were prospectively enrolled at emergency department admission (day 0) of 2 different hospitals: 1 for the exploratory cohort (180 patients) and 1 for the confirmatory cohort (104 patients). Deterioration was assessed over the next 7 days. Neither increased immature granulocyte levels nor monocyte differentiation blockade predicted patient worsening. Among more than 30 clinical, biological, and radiological parameters, the value of decreased P/F ratio and lymphopenia for prediction of further COVID-19 deterioration was strongly confirmed, and the loss of mHLA-DR was the only additional independent marker. Combined together in a simple OxyLymphoMono score, the 3 variables perfectly predicted patients who did not worsen and correctly predicted worsening in 59% of cases. By highlighting lymphocyte and monocyte defects as preceding COVID-19 deterioration, these results point on early immunosuppression in COVID-19 deterioration. Combining P/F ratio, lymphopenia, and loss of mHLA-DR together in a simple and robust score could offer a pragmatic method for COVID-19 patient stratification. Competing Interests: Conflict of interest statement. None declared. (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Leukocyte Biology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu