Potential biomarkers for fatal outcome prognosis in a cohort of hospitalized COVID‐19 patients with pre‐existing comorbidities

Author:

Madera‐Sandoval Ruth Lizzeth1ORCID,Cérbulo‐Vázquez Arturo2ORCID,Arriaga‐Pizano Lourdes Andrea1ORCID,Cabrera‐Rivera Graciela Libier13ORCID,Basilio‐Gálvez Edna14ORCID,Miranda‐Cruz Patricia Esther1ORCID,García de la Rosa María Teresa13ORCID,Prieto‐Chávez Jessica Lashkmin5ORCID,Rivero‐Arredondo Silvia Vanessa1ORCID,Cruz‐Cruz Alonso1ORCID,Rodríguez‐Hernández Daniela1ORCID,Salazar‐Ríos María Eugenia1ORCID,Salazar‐Ríos Enrique1ORCID,Serrano‐Molina Esli David1ORCID,De Lira‐Barraza Roberto Carlos6ORCID,Villanueva‐Compean Abel Humberto6ORCID,Esquivel‐Pineda Alejandra6ORCID,Ramírez‐Montes de Oca Rubén6ORCID,Unzueta‐Marta Omar6ORCID,Flores‐Padilla Guillermo6ORCID,Anda‐Garay Juan Carlos6ORCID,Sánchez‐Hurtado Luis Alejandro7ORCID,Calleja‐Alarcón Salvador7ORCID,Romero‐Gutiérrez Laura7ORCID,Torres‐Rosas Rafael8ORCID,Bonifaz Laura C.19ORCID,Pelayo Rosana1011ORCID,Márquez‐Márquez Edna2ORCID,López‐Macías Constantino I. I. I. Roberto1ORCID,Ferat‐Osorio Eduardo912ORCID

Affiliation:

1. Unidad de Investigación Médica en Inmunoquímica, Centro Médico Nacional Siglo XXI Instituto Mexicano del Seguro Social (IMSS) Ciudad de México Mexico

2. Servicio de Medicina Genómica Hospital General de México Ciudad de México Mexico

3. Posgrado en Inmunología Instituto Politécnico Nacional Ciudad de México Mexico

4. Posgrado de Ciencias Químicobiológicas, Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional Ciudad de México Mexico

5. Centro de Instrumentos, Centro Médico Nacional Siglo XXI Instituto Mexicano del Seguro Social (IMSS) Ciudad de México Mexico

6. Medicina Interna, Centro Médico Nacional Siglo XXI Instituto Mexicano del Seguro Social (IMSS) Ciudad de México Mexico

7. Unidad de Cuidados Intensivos, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI Instituto Mexicano del Seguro Social (IMSS) Ciudad de México Mexico

8. Laboratorio de Inmunología, Centro de Estudios en Ciencias de la Salud y la Enfermedad, Facultad de Odontología Universidad Autónoma “Benito Juárez” de Oaxaca (UABJO) Oaxaca de Juárez Mexico

9. Coordinación de Investigación en Salud, Centro Médico Nacional Siglo XXI Instituto Mexicano del Seguro Social Ciudad de México Mexico

10. Centro de Investigación Biomédica de Oriente IMSS Puebla Mexico

11. Unidad de Educación e Investigación, IMSS Ciudad de México Mexico

12. División de Investigación en Salud, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI Instituto Mexicano del Seguro Social (IMSS) Ciudad de México Mexico

Abstract

AbstractThe difficulty in predicting fatal outcomes in patients with coronavirus disease 2019 (COVID‐19) impacts the general morbidity and mortality due to severe acute respiratory syndrome‐coronavirus 2 infection, as it wears out the hospital services that care for these patients. Unfortunately, in several of the candidates for prognostic biomarkers proposed, the predictive power is compromised when patients have pre‐existing comorbidities. A cohort of 147 patients hospitalized for severe COVID‐19 was included in a descriptive, observational, single‐center, and prospective study. Patients were recruited during the first COVID‐19 pandemic wave (April–November 2020). Data were collected from the clinical history whereas immunophenotyping by multiparameter flow cytometry analysis allowed us to assess the expression of surface markers on peripheral leucocyte. Patients were grouped according to the outcome in survivors or non‐survivors. The prognostic value of leucocyte, cytokines or HLA‐DR, CD39, and CD73 was calculated. Hypertension and chronic renal failure but not obesity and diabetes were conditions more frequent among the deceased patient group. Mixed hypercytokinemia, including inflammatory (IL‐6) and anti‐inflammatory (IL‐10) cytokines, was more evident in deceased patients. In the deceased patient group, lymphopenia with a higher neutrophil‐lymphocyte ratio (NLR) value was present. HLA‐DR expression and the percentage of CD39+ cells were higher than non‐COVID‐19 patients but remained similar despite the outcome. Receiver operating characteristic analysis and cutoff value of NLR (69.6%, 9.4), percentage NLR (pNLR; 71.1%, 13.6), and IL‐6 (79.7%, 135.2 pg/mL). The expression of HLA‐DR, CD39, and CD73, as many serum cytokines (other than IL‐6) and chemokines levels do not show prognostic potential, were compared to NLR and pNLR values.

Publisher

Wiley

Subject

General Pharmacology, Toxicology and Pharmaceutics,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

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