Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19
OBJECTIVES:. The objective of this study was to compare the temporal dynamics of two viral-induced inflammatory proteins interferon gamma inducible protein-10 (IP-10) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), as well as C-reactive protein (CRP) among patients hospitalized...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-09-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000760 |
| _version_ | 1827339543767941120 |
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| author | Anthony Sophonsri, PharmD Diana Le, PharmD Mimi Lou, MA Pamela Ny, PharmD Emi Minejima, PharmD Allison B. Chambliss, PhD Paul Nieberg, MD Kimberly Shriner, MD Annie Wong-Beringer, PharmD |
| author_facet | Anthony Sophonsri, PharmD Diana Le, PharmD Mimi Lou, MA Pamela Ny, PharmD Emi Minejima, PharmD Allison B. Chambliss, PhD Paul Nieberg, MD Kimberly Shriner, MD Annie Wong-Beringer, PharmD |
| author_sort | Anthony Sophonsri, PharmD |
| collection | DOAJ |
| description | OBJECTIVES:. The objective of this study was to compare the temporal dynamics of two viral-induced inflammatory proteins interferon gamma inducible protein-10 (IP-10) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), as well as C-reactive protein (CRP) among patients hospitalized for COVID-19 and examine their prognostic significance.
DESIGN:. Prospective observational cohort study.
SETTING:. Multicenter, inpatient.
PATIENTS:. Adult patients infected with severe acute respiratory syndrome coronavirus 2 between March 2021 and October 2021.
INTERVENTIONS:. Patient sera were collected on days 1, 3, 5, and 7 of hospitalization. Levels of IP-10, TRAIL, and CRP were measured using a point-of-need diagnostic immunoassay platform (MeMed BV, MeMed, Haifa, Israel) and compared between patients grouped by disease severity (severe vs nonsevere).
MEASUREMENTS AND MAIN RESULTS:. Baseline characteristics were similar regardless of severity except for a higher prevalence of diabetes and heart failure among severe patients. The immune profile at admission was similar between groups; IP-10 and CRP levels generally decreased while TRAIL levels increased over time in all patients. However, the severe group had higher IP-10 (median 713 vs 328 pg/mL; p = 0.045) and lower TRAIL levels (median 21 vs 30 pg/mL; p = 0.003) on day 3 compared with nonsevere patients. A breakpoint IP-10 level of greater than or equal to 570 pg/mL and TRAIL level of less than 25 pg/mL on day 3 were associated with COVID-19 severity. Patients with elevated day 3 IP-10 levels (≥ 570 pg/mL) were more likely to experience prolonged recovery time (median 12 vs 3 d; p < 0.001). The severe group had prolonged use of corticosteroids (12 vs 5 d; p < 0.001) and had a higher rate of secondary infections (20% vs 6%; p = 0.04) and in-hospital mortality (20% vs 0%; p < 0.001) as compared with nonsevere patients.
CONCLUSIONS:. The observed patterns in host immune response revealed a turning point in COVID-19 disease on hospital day 3 and the potential utility of IP-10 and TRAIL as sensitive markers associated with disease severity and time to recovery. |
| first_indexed | 2024-03-07T20:02:12Z |
| format | Article |
| id | doaj.art-79fd66967d2d46a7a4395ef6281a8dc1 |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-03-07T20:02:12Z |
| publishDate | 2022-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-79fd66967d2d46a7a4395ef6281a8dc12024-02-28T06:47:00ZengWolters KluwerCritical Care Explorations2639-80282022-09-0149e076010.1097/CCE.0000000000000760202209000-00009Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19Anthony Sophonsri, PharmD0Diana Le, PharmD1Mimi Lou, MA2Pamela Ny, PharmD3Emi Minejima, PharmD4Allison B. Chambliss, PhD5Paul Nieberg, MD6Kimberly Shriner, MD7Annie Wong-Beringer, PharmD81 Department of Clinical Pharmacy, University of Southern California, School of Pharmacy, Los Angeles, CA.1 Department of Clinical Pharmacy, University of Southern California, School of Pharmacy, Los Angeles, CA.1 Department of Clinical Pharmacy, University of Southern California, School of Pharmacy, Los Angeles, CA.2 Department of Pharmacy, Huntington Hospital, Pasadena, CA.1 Department of Clinical Pharmacy, University of Southern California, School of Pharmacy, Los Angeles, CA.3 Department of Pathology, University of Southern California, Keck School of Medicine, Los Angeles, CA4 Department of Medicine-Infectious Diseases, Huntington Hospital, Pasadena, CA.4 Department of Medicine-Infectious Diseases, Huntington Hospital, Pasadena, CA.1 Department of Clinical Pharmacy, University of Southern California, School of Pharmacy, Los Angeles, CA.OBJECTIVES:. The objective of this study was to compare the temporal dynamics of two viral-induced inflammatory proteins interferon gamma inducible protein-10 (IP-10) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), as well as C-reactive protein (CRP) among patients hospitalized for COVID-19 and examine their prognostic significance. DESIGN:. Prospective observational cohort study. SETTING:. Multicenter, inpatient. PATIENTS:. Adult patients infected with severe acute respiratory syndrome coronavirus 2 between March 2021 and October 2021. INTERVENTIONS:. Patient sera were collected on days 1, 3, 5, and 7 of hospitalization. Levels of IP-10, TRAIL, and CRP were measured using a point-of-need diagnostic immunoassay platform (MeMed BV, MeMed, Haifa, Israel) and compared between patients grouped by disease severity (severe vs nonsevere). MEASUREMENTS AND MAIN RESULTS:. Baseline characteristics were similar regardless of severity except for a higher prevalence of diabetes and heart failure among severe patients. The immune profile at admission was similar between groups; IP-10 and CRP levels generally decreased while TRAIL levels increased over time in all patients. However, the severe group had higher IP-10 (median 713 vs 328 pg/mL; p = 0.045) and lower TRAIL levels (median 21 vs 30 pg/mL; p = 0.003) on day 3 compared with nonsevere patients. A breakpoint IP-10 level of greater than or equal to 570 pg/mL and TRAIL level of less than 25 pg/mL on day 3 were associated with COVID-19 severity. Patients with elevated day 3 IP-10 levels (≥ 570 pg/mL) were more likely to experience prolonged recovery time (median 12 vs 3 d; p < 0.001). The severe group had prolonged use of corticosteroids (12 vs 5 d; p < 0.001) and had a higher rate of secondary infections (20% vs 6%; p = 0.04) and in-hospital mortality (20% vs 0%; p < 0.001) as compared with nonsevere patients. CONCLUSIONS:. The observed patterns in host immune response revealed a turning point in COVID-19 disease on hospital day 3 and the potential utility of IP-10 and TRAIL as sensitive markers associated with disease severity and time to recovery.http://journals.lww.com/10.1097/CCE.0000000000000760 |
| spellingShingle | Anthony Sophonsri, PharmD Diana Le, PharmD Mimi Lou, MA Pamela Ny, PharmD Emi Minejima, PharmD Allison B. Chambliss, PhD Paul Nieberg, MD Kimberly Shriner, MD Annie Wong-Beringer, PharmD Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19 Critical Care Explorations |
| title | Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19 |
| title_full | Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19 |
| title_fullStr | Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19 |
| title_full_unstemmed | Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19 |
| title_short | Temporal Dynamics of Host Immune Response Associated With Disease Severity and Time to Recovery in Patients Hospitalized for COVID-19 |
| title_sort | temporal dynamics of host immune response associated with disease severity and time to recovery in patients hospitalized for covid 19 |
| url | http://journals.lww.com/10.1097/CCE.0000000000000760 |
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