Severe COVID-19 is characterised by inflammation and immature myeloid cells early in disease progression. Issue 4 (April 2022)

• Record Type: Journal Article
• Authors: Townsend, Liam; Dyer, Adam H.; Naughton, Aifric; Imangaliyev, Sultan; Dunne, Jean; Kiersey, Rachel; Holden, Dean; Mooney, Aoife; Leavy, Deirdre; Ridge, Katie; Sugrue, Jamie; Aldoseri, Mubarak; Kelliher, Jo Hannah; Hennessy, Martina; Byrne, Declan; Browne, Paul; Bacon, Christopher L.; Doyle, Catriona; O'Riordan, Ruth; McLaughlin, Anne-Marie; Bannan, Ciaran; Martin-Loeches, Ignacio; White, Arthur; McLoughlin, Rachel M.; Bergin, Colm; Bourke, Nollaig M.; O'Farrelly, Cliona; Conlon, Niall; Cheallaigh, Clíona Ní
• Is Part Of: Heliyon. Volume 8:Issue 4(2022)
• Publication Date: 2022-04
• Subjects: COVID-19 -- Immune phenotype -- Neutrophil maturity -- Machine learning -- Biomarkers; Research -- Periodicals; Medical sciences -- Periodicals; Natural history -- Periodicals; Social sciences -- Periodicals; Earth sciences -- Periodicals; Physical sciences -- Periodicals; 507.2
• DOI: 10.1016/j.heliyon.2022.e09230
• Languages: English
• ISSNs: 2405-8440

Abstract

Abstract: SARS-CoV-2 infection causes a wide spectrum of disease severity. Identifying the immunological characteristics of severe disease and the risk factors for their development are important in the management of COVID-19. This study aimed to identify and rank clinical and immunological features associated with progression to severe COVID-19 in order to investigate an immunological signature of severe disease. One hundred and eight patients with positive SARS-CoV-2 PCR were recruited. Routine clinical and laboratory markers were measured, as well as myeloid and lymphoid whole-blood immunophenotyping and measurement of the pro-inflammatory cytokines IL-6 and soluble CD25. All analysis was carried out in a routine hospital diagnostic laboratory. Univariate analysis demonstrated that severe disease was most strongly associated with elevated CRP and IL-6, loss of DLA-DR expression on monocytes and CD10 expression on neutrophils. Unbiased machine learning demonstrated that these four features were strongly associated with severe disease, with an average prediction score for severe disease of 0.925. These results demonstrate that these four markers could be used to identify patients developing severe COVID-19 and allow timely delivery of therapeutics. Graphical abstract: Image 1 Highlights: Severe COVID-19 is characterised by a combination of emergency myelopoiesis and inflammation. These changes can be rapidly identified in a diagnostic laboratory, facilitating intervention. This disease signature was derived from a cohort of patients with a wide range of ages, frailty and COVID-19 severity. Abstract : COVID-19; Immune phenotype; Neutrophil maturity; Machine learning; Biomarkers.