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Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients

All severe cases of SARS-CoV-2 infections are characterized by a high risk of disease progression towards ARDS, leading to a bad outcome. Respiratory symptoms in COVID-19 patients often do not correspond to disease’s worsening. In our sample, median age was 74 years (72–75) and 54% were men. The med...

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Autores principales: Regolo, Matteo, Sorce, Alessandra, Vaccaro, Mauro, Colaci, Michele, Stancanelli, Benedetta, Natoli, Giuseppe, Motta, Massimo, Isaia, Ivan, Castelletti, Federica, Giangreco, Federica, Fichera, Daniela, Aparo, Paola, Lanzafame, Alessandra, Russo, Mario, Santangelo, Nicola, Noto, Paola, Malatino, Lorenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299383/
https://www.ncbi.nlm.nih.gov/pubmed/37373750
http://dx.doi.org/10.3390/jcm12124057
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author Regolo, Matteo
Sorce, Alessandra
Vaccaro, Mauro
Colaci, Michele
Stancanelli, Benedetta
Natoli, Giuseppe
Motta, Massimo
Isaia, Ivan
Castelletti, Federica
Giangreco, Federica
Fichera, Daniela
Aparo, Paola
Lanzafame, Alessandra
Russo, Mario
Santangelo, Nicola
Noto, Paola
Malatino, Lorenzo
author_facet Regolo, Matteo
Sorce, Alessandra
Vaccaro, Mauro
Colaci, Michele
Stancanelli, Benedetta
Natoli, Giuseppe
Motta, Massimo
Isaia, Ivan
Castelletti, Federica
Giangreco, Federica
Fichera, Daniela
Aparo, Paola
Lanzafame, Alessandra
Russo, Mario
Santangelo, Nicola
Noto, Paola
Malatino, Lorenzo
author_sort Regolo, Matteo
collection PubMed
description All severe cases of SARS-CoV-2 infections are characterized by a high risk of disease progression towards ARDS, leading to a bad outcome. Respiratory symptoms in COVID-19 patients often do not correspond to disease’s worsening. In our sample, median age was 74 years (72–75) and 54% were men. The median period of hospitalization was 9 days. Firstly, we observed a significant asynchronous trend of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in 764 selected among 963 patients, who were consecutively recruited in two hospitals (Cannizzaro, S. Marco) in Catania, Italy. NLR values in deceased patients showed an increase from baseline over time. By contrast, CRP tended to fall from baseline to median day of hospitalization in all three subgroups, but steeply increased at the end of hospitalization only in ICU-admitted patients. Then, we evaluated the relationships between NLR and CRP as continuous variables with PaO(2)/FiO(2) ratio (P/F). NLR was an independent predictor of mortality (HR: 1.77, p < 0.0001), while ICU admission was more significantly associated with CRP (HR: 1.70, p < 0.0001). Finally, age, neutrophils, CRP, and lymphocytes are significantly and directly linked to P/F, while the influence of inflammation on P/F, reflected by CRP, was also mediated by neutrophils.
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spelling pubmed-102993832023-06-28 Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients Regolo, Matteo Sorce, Alessandra Vaccaro, Mauro Colaci, Michele Stancanelli, Benedetta Natoli, Giuseppe Motta, Massimo Isaia, Ivan Castelletti, Federica Giangreco, Federica Fichera, Daniela Aparo, Paola Lanzafame, Alessandra Russo, Mario Santangelo, Nicola Noto, Paola Malatino, Lorenzo J Clin Med Article All severe cases of SARS-CoV-2 infections are characterized by a high risk of disease progression towards ARDS, leading to a bad outcome. Respiratory symptoms in COVID-19 patients often do not correspond to disease’s worsening. In our sample, median age was 74 years (72–75) and 54% were men. The median period of hospitalization was 9 days. Firstly, we observed a significant asynchronous trend of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in 764 selected among 963 patients, who were consecutively recruited in two hospitals (Cannizzaro, S. Marco) in Catania, Italy. NLR values in deceased patients showed an increase from baseline over time. By contrast, CRP tended to fall from baseline to median day of hospitalization in all three subgroups, but steeply increased at the end of hospitalization only in ICU-admitted patients. Then, we evaluated the relationships between NLR and CRP as continuous variables with PaO(2)/FiO(2) ratio (P/F). NLR was an independent predictor of mortality (HR: 1.77, p < 0.0001), while ICU admission was more significantly associated with CRP (HR: 1.70, p < 0.0001). Finally, age, neutrophils, CRP, and lymphocytes are significantly and directly linked to P/F, while the influence of inflammation on P/F, reflected by CRP, was also mediated by neutrophils. MDPI 2023-06-15 /pmc/articles/PMC10299383/ /pubmed/37373750 http://dx.doi.org/10.3390/jcm12124057 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Regolo, Matteo
Sorce, Alessandra
Vaccaro, Mauro
Colaci, Michele
Stancanelli, Benedetta
Natoli, Giuseppe
Motta, Massimo
Isaia, Ivan
Castelletti, Federica
Giangreco, Federica
Fichera, Daniela
Aparo, Paola
Lanzafame, Alessandra
Russo, Mario
Santangelo, Nicola
Noto, Paola
Malatino, Lorenzo
Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients
title Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients
title_full Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients
title_fullStr Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients
title_full_unstemmed Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients
title_short Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients
title_sort assessing humoral immuno-inflammatory pathways associated with respiratory failure in covid-19 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299383/
https://www.ncbi.nlm.nih.gov/pubmed/37373750
http://dx.doi.org/10.3390/jcm12124057
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