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MeSH Disease

COVID-19 (1)


HGNC Genes

SARS-CoV-2 proteins

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    PREDICTIVE IMMUNOLOGICAL, VIROLOGICAL, AND ROUTINE LABORATORY MARKERS FOR CRITICAL COVID-19 MESHD ON ADMISSION.Immunocovid study

    Authors: Mercedes Garcia Gasalla; Juana M Ferrer; Pablo A Fraile-Ribot; Adrian Ferre-Beltran; Adrian Rodriguez; Natalia Martinez-Pomar; Luisa Ramon-Clar; Amanda Iglesias; Francisco Fanjul; Joan A Pou; Isabel LLompart; Ines Losada; Nuria Toledo; Jaime Pons; Antonio Oliver; Melchor Riera; Javier Murillas

    doi:10.1101/2021.03.17.21253816 Date: 2021-03-20 Source: medRxiv

    Introduction: Early identification of COVID-19 MESHD patients at risk of critical illness is challenging for clinicians. Immunological, virological, and routine laboratory markers to be used in addition to clinical data are needed. Aim and methods: Blood tests to measure neutrophil/lymphocyte ratio (NLR), levels of ferritin, CRP HGNC, D-dimer, complement components (C3, C4), lymphocyte subsets, and cytokines, and SARS-Cov2 RT-PCR tests were performed in COVID-19 MESHD confirmed cases within 48 hours of admission. Cycle threshold (Ct) values were determined by RT-PCR from oral or nasopharyngeal swabs on the day of admission. Severity of symptoms was categorized as mild (grade 1), severe (grade 2), and critical (grade 3). Results: 120 patients were included. COVID-19 MESHD was mild in 49, severe in 32, and critical in 39. Ferritin >370 ng/mL (OR 16.4, 95% CI 5.3-50.8), D-dimer >440 ng/mL (OR 5.45, 95% CI 2.36-12.61), CRP >7.65 mg/dL (OR 11.54, 95% CI 4.3-30.8), NLR >3.77 (OR 13.4, 95% CI 4.3-41.1), IL-6 HGNC >142.5 pg/mL (OR 8.76, 95% CI 3.56-21.54), IL-10 HGNC >10.8 pg/mL (OR 16.45, 95% CI 5.32-50.81), sIL-2r (sCD25) >804.5 pg/mL (OR 14.06, 95% CI 4.56-43.28), IL-1Ra HGNC >88.4 pg/mL (OR 4.54, 95% CI 2.03-10.17), and IL-18 HGNC >144 pg/mL (OR 17.85, 95% CI 6.54-48.78) were associated with critical COVID-19 MESHD in the univariate age-adjusted analysis. In the multivariate age-adjusted analysis, this association was confirmed only for ferritin, CRP HGNC,NLR, IL-10 HGNC, sIL-2r, and IL-18 HGNC. T, B, and NK cells were significantly decreased in critical patients. SARS-CoV-2 was undetected in blood except in 3 patients with indeterminate results. Ct values determined by RT-PCR from oral/nasopharyngeal swabs on admission were not related to symptom severity. Conclusion: levels of ferritin, D-dimer, CRP HGNC, NLR, and cytokines and cytokine receptors IL-6 HGNC, IL1-Ra HGNC, sCD25, IL-18 HGNC, and IL-10 HGNC, taken together with clinical data, can contribute to the early identification of critical COVID-19 MESHD patients.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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