Circulating activated neutrophils in COVID-19: An independent predictor for mechanical ventilation and death
| Autor: | Jalila Alshekaili, Khuloud Al Maamari, Allan Aurelio, Ghalib Al Khadouri, David Dennison, Houda Al Hinai, Sahimah Al Mamari, Murtadha Al Khabori |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) Neutrophils medicine.medical_treatment 030106 microbiology Inflammation Infectious and parasitic diseases RC109-216 Article Neutrophil Activation Aberrant neutrophil response 03 medical and health sciences 0302 clinical medicine Immune system Risk Factors Diabetes mellitus medicine Humans 030212 general & internal medicine Retrospective Studies Innate immunity Mechanical ventilation Innate immune system SARS-CoV-2 business.industry Optical Imaging Area under the curve COVID-19 Biomarker General Medicine Odds ratio Middle Aged Flow Cytometry medicine.disease Respiration Artificial Immunity Innate Death Infectious Diseases Immunology Biomarker (medicine) Female Activated neutrophils medicine.symptom Critical illness business Biomarkers |
| Zdroj: | International Journal of Infectious Diseases, Vol 106, Iss, Pp 155-159 (2021) International Journal of Infectious Diseases |
| ISSN: | 1201-9712 |
| DOI: | 10.1016/j.ijid.2021.03.066 |
| Popis: | Objectives: Critical illness in COVID-19 is attributed to an exaggerated host immune response. Since neutrophils are the major component of innate immunity, we hypothesize that the quantum of activated neutrophils in the blood may predict an adverse outcome. Design: In a retrospective study of 300 adult patients with confirmed COVID-19, we analyzed the impact of neutrophil activation (NEUT-RI), interleukin-6 (IL-6) and the established clinical risk factors of age, diabetes, obesity and hypertension on the clinical outcome. Results: Significant predictors of the need for mechanical ventilation were NEUT-RI (Odds Ratio (OR) = 1.22, P < 0.001), diabetes (OR = 2.56, P = 0.00846) and obesity (OR = 6.55, P < 0.001). For death, the significant predictors were NEUT-RI (OR = 1.14, P = 0.00432), diabetes (OR = 4.11, P = 0.00185) and age (OR = 1.04, P = 0.00896). The optimal cut-off value for NEUT-RI to predict mechanical ventilation and death was 52 fluorescence intensity units (sensitivity 44%, specificity 88%, area under the curve 0.67 and 44%, 86%, 0.64, respectively). Conclusion: This finding supports an aberrant neutrophil response in COVID-19, likely due to uncontained viral replication, tissue hypoxia and exacerbated inflammation, introduces a novel biomarker for rapid monitoring and opens new avenues for therapeutic strategies. |
| Databáze: | OpenAIRE |
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