| Autor: |
Michael Lu, Callie Drohan, William Bain, Faraaz A. Shah, Matthew Bittner, John Evankovich, Niall Prendergast, Matthew Hensley, Tomeka Suber, Meghan Fitzpatrick, Raj Ramanan, Holt Murray, Caitlin Schaefer, Shulin Qin, Xiaohong Wang, Yingze Zhang, Seyed M. Nouraie, Heather Gentry, Cathy Kessinger, Asha Patel, Bernard J. Macatangay, Jana Jacobs, John Mellors, Janet S. Lee, Prabir Ray, Anuradha Ray, Barbara Methé, Alison Morris, Bryan J. McVerry, Georgios D. Kitsios |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
medRxiv |
| Popis: |
PurposeEnhanced understanding of the dynamic changes in the dysregulated inflammatory response in COVID-19 may help improve patient selection and timing for immunomodulatory therapies.MethodsWe enrolled 323 COVID-19 inpatients on different levels of baseline respiratory support: i) Low Flow Oxygen (37%), ii) Non-Invasive Ventilation or High Flow Oxygen (NIV_HFO, 29%), iii) Invasive Mechanical Ventilation (IMV, 27%), and iv) Extracorporeal Membrane Oxygenation (ECMO, 7%). We collected plasma samples upon enrollment and days 5 and 10 to measure host-response biomarkers. We classified subjects into inflammatory subphenotypes using two validated predictive models. We examined clinical, biomarker and subphenotype trajectories and outcomes during hospitalization.ResultsIL-6, procalcitonin, and Angiopoietin-2 were persistently elevated in patients at higher levels of respiratory support, whereas sRAGE displayed the inverse pattern. Patients on NIV_HFO at baseline had the most dynamic clinical trajectory, with 26% eventually requiring intubation and exhibiting worse 60-day mortality than IMV patients at baseline (67% vs. 35%, pConclusionsLongitudinal study of systemic host responses in COVID-19 revealed substantial and predictive inter-individual variability, influenced by baseline levels of respiratory support and concurrent immunomodulatory therapies. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
