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COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity

Although there is strong evidence that SARS-CoV-2 infection is associated with adverse outcomes in certain ethnic groups, the association of disease severity and risk factors such as comorbidities and biomarkers with racial disparities remains undefined. This retrospective study between March 2020 a...

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Autores principales: Heissig, Beate, Salama, Yousef, Iakoubov, Roman, Vehreschild, Joerg Janne, Rios, Ricardo, Nogueira, Tatiane, Vehreschild, Maria J. G. T., Stecher, Melanie, Mori, Hirotake, Lanznaster, Julia, Adachi, Eisuke, Jakob, Carolin, Tabe, Yoko, Ruethrich, Maria, Borgmann, Stefan, Naito, Toshio, Wille, Kai, Valenti, Simon, Hower, Martin, Hattori, Nobutaka, Rieg, Siegbert, Nagaoka, Tetsutaro, Jensen, Bjoern-Erik, Yotsuyanagi, Hiroshi, Hertenstein, Bernd, Ogawa, Hideoki, Wyen, Christoph, Kominami, Eiki, Roemmele, Christoph, Takahashi, Satoshi, Rupp, Jan, Takahashi, Kazuhisa, Hanses, Frank, Hattori, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599040/
https://www.ncbi.nlm.nih.gov/pubmed/36289811
http://dx.doi.org/10.3390/biomedicines10102549
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author Heissig, Beate
Salama, Yousef
Iakoubov, Roman
Vehreschild, Joerg Janne
Rios, Ricardo
Nogueira, Tatiane
Vehreschild, Maria J. G. T.
Stecher, Melanie
Mori, Hirotake
Lanznaster, Julia
Adachi, Eisuke
Jakob, Carolin
Tabe, Yoko
Ruethrich, Maria
Borgmann, Stefan
Naito, Toshio
Wille, Kai
Valenti, Simon
Hower, Martin
Hattori, Nobutaka
Rieg, Siegbert
Nagaoka, Tetsutaro
Jensen, Bjoern-Erik
Yotsuyanagi, Hiroshi
Hertenstein, Bernd
Ogawa, Hideoki
Wyen, Christoph
Kominami, Eiki
Roemmele, Christoph
Takahashi, Satoshi
Rupp, Jan
Takahashi, Kazuhisa
Hanses, Frank
Hattori, Koichi
author_facet Heissig, Beate
Salama, Yousef
Iakoubov, Roman
Vehreschild, Joerg Janne
Rios, Ricardo
Nogueira, Tatiane
Vehreschild, Maria J. G. T.
Stecher, Melanie
Mori, Hirotake
Lanznaster, Julia
Adachi, Eisuke
Jakob, Carolin
Tabe, Yoko
Ruethrich, Maria
Borgmann, Stefan
Naito, Toshio
Wille, Kai
Valenti, Simon
Hower, Martin
Hattori, Nobutaka
Rieg, Siegbert
Nagaoka, Tetsutaro
Jensen, Bjoern-Erik
Yotsuyanagi, Hiroshi
Hertenstein, Bernd
Ogawa, Hideoki
Wyen, Christoph
Kominami, Eiki
Roemmele, Christoph
Takahashi, Satoshi
Rupp, Jan
Takahashi, Kazuhisa
Hanses, Frank
Hattori, Koichi
author_sort Heissig, Beate
collection PubMed
description Although there is strong evidence that SARS-CoV-2 infection is associated with adverse outcomes in certain ethnic groups, the association of disease severity and risk factors such as comorbidities and biomarkers with racial disparities remains undefined. This retrospective study between March 2020 and February 2021 explores COVID-19 risk factors as predictors for patients’ disease progression through country comparison. Disease severity predictors in Germany and Japan were cardiovascular-associated comorbidities, dementia, and age. We adjusted age, sex, body mass index, and history of cardiovascular disease comorbidity in the country cohorts using a propensity score matching (PSM) technique to reduce the influence of differences in sample size and the surprisingly young, lean Japanese cohort. Analysis of the 170 PSM pairs confirmed that 65.29% of German and 85.29% of Japanese patients were in the uncomplicated phase. More German than Japanese patients were admitted in the complicated and critical phase. Ethnic differences were identified in patients without cardiovascular comorbidities. Japanese patients in the uncomplicated phase presented a suppressed inflammatory response and coagulopathy with hypocoagulation. In contrast, German patients exhibited a hyperactive inflammatory response and coagulopathy with hypercoagulation. These differences were less pronounced in patients in the complicated phase or with cardiovascular diseases. Coagulation/fibrinolysis-associated biomarkers rather than inflammatory-related biomarkers predicted disease severity in patients with cardiovascular comorbidities: platelet counts were associated with severe illness in German patients. In contrast, high D-dimer and fibrinogen levels predicted disease severity in Japanese patients. Our comparative study indicates that ethnicity influences COVID-19-associated biomarker expression linked to the inflammatory and coagulation (thrombo-inflammatory) response. Future studies will be necessary to determine whether these differences contributed to the less severe disease progression observed in Japanese COVID-19 patients compared with those in Germany.
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spelling pubmed-95990402022-10-27 COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity Heissig, Beate Salama, Yousef Iakoubov, Roman Vehreschild, Joerg Janne Rios, Ricardo Nogueira, Tatiane Vehreschild, Maria J. G. T. Stecher, Melanie Mori, Hirotake Lanznaster, Julia Adachi, Eisuke Jakob, Carolin Tabe, Yoko Ruethrich, Maria Borgmann, Stefan Naito, Toshio Wille, Kai Valenti, Simon Hower, Martin Hattori, Nobutaka Rieg, Siegbert Nagaoka, Tetsutaro Jensen, Bjoern-Erik Yotsuyanagi, Hiroshi Hertenstein, Bernd Ogawa, Hideoki Wyen, Christoph Kominami, Eiki Roemmele, Christoph Takahashi, Satoshi Rupp, Jan Takahashi, Kazuhisa Hanses, Frank Hattori, Koichi Biomedicines Article Although there is strong evidence that SARS-CoV-2 infection is associated with adverse outcomes in certain ethnic groups, the association of disease severity and risk factors such as comorbidities and biomarkers with racial disparities remains undefined. This retrospective study between March 2020 and February 2021 explores COVID-19 risk factors as predictors for patients’ disease progression through country comparison. Disease severity predictors in Germany and Japan were cardiovascular-associated comorbidities, dementia, and age. We adjusted age, sex, body mass index, and history of cardiovascular disease comorbidity in the country cohorts using a propensity score matching (PSM) technique to reduce the influence of differences in sample size and the surprisingly young, lean Japanese cohort. Analysis of the 170 PSM pairs confirmed that 65.29% of German and 85.29% of Japanese patients were in the uncomplicated phase. More German than Japanese patients were admitted in the complicated and critical phase. Ethnic differences were identified in patients without cardiovascular comorbidities. Japanese patients in the uncomplicated phase presented a suppressed inflammatory response and coagulopathy with hypocoagulation. In contrast, German patients exhibited a hyperactive inflammatory response and coagulopathy with hypercoagulation. These differences were less pronounced in patients in the complicated phase or with cardiovascular diseases. Coagulation/fibrinolysis-associated biomarkers rather than inflammatory-related biomarkers predicted disease severity in patients with cardiovascular comorbidities: platelet counts were associated with severe illness in German patients. In contrast, high D-dimer and fibrinogen levels predicted disease severity in Japanese patients. Our comparative study indicates that ethnicity influences COVID-19-associated biomarker expression linked to the inflammatory and coagulation (thrombo-inflammatory) response. Future studies will be necessary to determine whether these differences contributed to the less severe disease progression observed in Japanese COVID-19 patients compared with those in Germany. MDPI 2022-10-12 /pmc/articles/PMC9599040/ /pubmed/36289811 http://dx.doi.org/10.3390/biomedicines10102549 Text en © 2022 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
Heissig, Beate
Salama, Yousef
Iakoubov, Roman
Vehreschild, Joerg Janne
Rios, Ricardo
Nogueira, Tatiane
Vehreschild, Maria J. G. T.
Stecher, Melanie
Mori, Hirotake
Lanznaster, Julia
Adachi, Eisuke
Jakob, Carolin
Tabe, Yoko
Ruethrich, Maria
Borgmann, Stefan
Naito, Toshio
Wille, Kai
Valenti, Simon
Hower, Martin
Hattori, Nobutaka
Rieg, Siegbert
Nagaoka, Tetsutaro
Jensen, Bjoern-Erik
Yotsuyanagi, Hiroshi
Hertenstein, Bernd
Ogawa, Hideoki
Wyen, Christoph
Kominami, Eiki
Roemmele, Christoph
Takahashi, Satoshi
Rupp, Jan
Takahashi, Kazuhisa
Hanses, Frank
Hattori, Koichi
COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity
title COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity
title_full COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity
title_fullStr COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity
title_full_unstemmed COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity
title_short COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity
title_sort covid-19 severity and thrombo-inflammatory response linked to ethnicity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599040/
https://www.ncbi.nlm.nih.gov/pubmed/36289811
http://dx.doi.org/10.3390/biomedicines10102549
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