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Definition of the Immune Parameters Related to COVID-19 Severity
A relevant portion of patients with disease caused by the severe acute respiratory syndrome coronavirus 2 (COVID-19) experience negative outcome, and several laboratory tests have been proposed to predict disease severity. Among others, dramatic changes in peripheral blood cells have been described....
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971756/ https://www.ncbi.nlm.nih.gov/pubmed/35371011 http://dx.doi.org/10.3389/fimmu.2022.850846 |
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author | Birindelli, Sarah Tarkowski, Maciej S. Gallucci, Marcello Schiuma, Marco Covizzi, Alice Lewkowicz, Przemysław Aloisio, Elena Falvella, Felicia Stefania Dolci, Alberto Riva, Agostino Galli, Massimo Panteghini, Mauro |
author_facet | Birindelli, Sarah Tarkowski, Maciej S. Gallucci, Marcello Schiuma, Marco Covizzi, Alice Lewkowicz, Przemysław Aloisio, Elena Falvella, Felicia Stefania Dolci, Alberto Riva, Agostino Galli, Massimo Panteghini, Mauro |
author_sort | Birindelli, Sarah |
collection | PubMed |
description | A relevant portion of patients with disease caused by the severe acute respiratory syndrome coronavirus 2 (COVID-19) experience negative outcome, and several laboratory tests have been proposed to predict disease severity. Among others, dramatic changes in peripheral blood cells have been described. We developed and validated a laboratory score solely based on blood cell parameters to predict survival in hospitalized COVID-19 patients. We retrospectively analyzed 1,619 blood cell count from 226 consecutively hospitalized COVID-19 patients to select parameters for inclusion in a laboratory score predicting severity of disease and survival. The score was derived from lymphocyte- and granulocyte-associated parameters and validated on a separate cohort of 140 consecutive COVID-19 patients. Using ROC curve analysis, a best cutoff for score of 30.6 was derived, which was associated to an overall 82.0% sensitivity (95% CI: 78–84) and 82.5% specificity (95% CI: 80–84) for detecting outcome. The scoring trend effectively separated survivor and non-survivor groups, starting 2 weeks before the end of the hospitalization period. Patients’ score time points were also classified into mild, moderate, severe, and critical according to the symptomatic oxygen therapy administered. Fluctuations of the score should be recorded to highlight a favorable or unfortunate trend of the disease. The predictive score was found to reflect and anticipate the disease gravity, defined by the type of the oxygen support used, giving a proof of its clinical relevance. It offers a fast and reliable tool for supporting clinical decisions and, most important, triage in terms of not only prioritization but also allocation of limited medical resources, especially in the period when therapies are still symptomatic and many are under development. In fact, a prolonged and progressive increase of the score can suggest impaired chances of survival and/or an urgent need for intensive care unit admission. |
format | Online Article Text |
id | pubmed-8971756 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89717562022-04-02 Definition of the Immune Parameters Related to COVID-19 Severity Birindelli, Sarah Tarkowski, Maciej S. Gallucci, Marcello Schiuma, Marco Covizzi, Alice Lewkowicz, Przemysław Aloisio, Elena Falvella, Felicia Stefania Dolci, Alberto Riva, Agostino Galli, Massimo Panteghini, Mauro Front Immunol Immunology A relevant portion of patients with disease caused by the severe acute respiratory syndrome coronavirus 2 (COVID-19) experience negative outcome, and several laboratory tests have been proposed to predict disease severity. Among others, dramatic changes in peripheral blood cells have been described. We developed and validated a laboratory score solely based on blood cell parameters to predict survival in hospitalized COVID-19 patients. We retrospectively analyzed 1,619 blood cell count from 226 consecutively hospitalized COVID-19 patients to select parameters for inclusion in a laboratory score predicting severity of disease and survival. The score was derived from lymphocyte- and granulocyte-associated parameters and validated on a separate cohort of 140 consecutive COVID-19 patients. Using ROC curve analysis, a best cutoff for score of 30.6 was derived, which was associated to an overall 82.0% sensitivity (95% CI: 78–84) and 82.5% specificity (95% CI: 80–84) for detecting outcome. The scoring trend effectively separated survivor and non-survivor groups, starting 2 weeks before the end of the hospitalization period. Patients’ score time points were also classified into mild, moderate, severe, and critical according to the symptomatic oxygen therapy administered. Fluctuations of the score should be recorded to highlight a favorable or unfortunate trend of the disease. The predictive score was found to reflect and anticipate the disease gravity, defined by the type of the oxygen support used, giving a proof of its clinical relevance. It offers a fast and reliable tool for supporting clinical decisions and, most important, triage in terms of not only prioritization but also allocation of limited medical resources, especially in the period when therapies are still symptomatic and many are under development. In fact, a prolonged and progressive increase of the score can suggest impaired chances of survival and/or an urgent need for intensive care unit admission. Frontiers Media S.A. 2022-03-18 /pmc/articles/PMC8971756/ /pubmed/35371011 http://dx.doi.org/10.3389/fimmu.2022.850846 Text en Copyright © 2022 Birindelli, Tarkowski, Gallucci, Schiuma, Covizzi, Lewkowicz, Aloisio, Falvella, Dolci, Riva, Galli and Panteghini https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Birindelli, Sarah Tarkowski, Maciej S. Gallucci, Marcello Schiuma, Marco Covizzi, Alice Lewkowicz, Przemysław Aloisio, Elena Falvella, Felicia Stefania Dolci, Alberto Riva, Agostino Galli, Massimo Panteghini, Mauro Definition of the Immune Parameters Related to COVID-19 Severity |
title | Definition of the Immune Parameters Related to COVID-19 Severity |
title_full | Definition of the Immune Parameters Related to COVID-19 Severity |
title_fullStr | Definition of the Immune Parameters Related to COVID-19 Severity |
title_full_unstemmed | Definition of the Immune Parameters Related to COVID-19 Severity |
title_short | Definition of the Immune Parameters Related to COVID-19 Severity |
title_sort | definition of the immune parameters related to covid-19 severity |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971756/ https://www.ncbi.nlm.nih.gov/pubmed/35371011 http://dx.doi.org/10.3389/fimmu.2022.850846 |
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