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Zhang L, Wang Z, Lyu F, Liu C, Li C, Liu W, Ma X, Zhou J, Qian X, Qian Z, Lu Y. Characterizing distinct profiles of immune and inflammatory response with age to Omicron infection. Front Immunol 2023; 14:1189482. [PMID: 37457688 PMCID: PMC10348361 DOI: 10.3389/fimmu.2023.1189482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background Understanding inflammatory and immune responses to Omicron infection based on age is crucial when addressing this global health threat. However, the lacking of comprehensive elucidation hinders the development of distinct treatments tailored to different age populations. Methods 1299 cases of Omicron infection in Shanghai were enrolled between April 10, 2022 and June 3, 2022, dividing into three groups by ages: Adult group (18-59 years), Old group (60-79 years), and Elder group (≥ 80 years). Laboratory data including inflammatory cytokines, cellular, and humoral immunity were collected and analyzed. Results The mean age of Adult, Old, and Elder groups were 44.14, 69.98, and 89.35 years, respectively, with 40.9% being men. The Elder group patients exhibited higher white blood cell (WBC) counts and elevated levels of inflammatory cytokines, but their lymphocyte counts were relatively lower. In comparison to the Old group patients, the Elder group patients demonstrated significantly lower CD3+ T-cell counts, CD3+ T-cell proportion, CD4+ T-cell counts, CD8+ T-cell counts, and CD19+ B-cell counts, while the NK-cell counts were higher. Omicron negative patients displayed a higher proportion of CD19+ B-cells and higher levels of Complement-3 and IL-17 compared to the positive patients in the Old group. Omicron negative patients had lower WBC counts, CD3+CD8+ T-cells proportion, and the levels of serum amyloid A and IgA in the Elder group, but the CD4+/CD8+ ratio was higher. Conclusions Our study identified the distinct profiles of inflammatory and immune responses to Omicron infection varying with age and highlighted the diverse correlations between the levels of various biomarkers and Omicron infected/convalescent patients.
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Affiliation(s)
- Lina Zhang
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhanwen Wang
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Lyu
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Chun Liu
- Respiratory and Critical Care Medicine Department, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chunhui Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Liu
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinhua Ma
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jieyu Zhou
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Xinyu Qian
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Zhaoxin Qian
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yong Lu
- Department of Radiology, Ruijin Hospital Luwan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Chung HP, Tang YH, Chen CY, Chen CH, Chang WK, Kuo KC, Chen YT, Wu JC, Lin CY, Wang CJ. Outcome prediction in hospitalized COVID-19 patients: Comparison of the performance of five severity scores. Front Med (Lausanne) 2023; 10:1121465. [PMID: 36844229 PMCID: PMC9945531 DOI: 10.3389/fmed.2023.1121465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/26/2023] [Indexed: 02/10/2023] Open
Abstract
Background The aim of our study was to externally validate the predictive capability of five developed coronavirus disease 2019 (COVID-19)-specific prognostic tools, including the COVID-19 Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Shang COVID severity score, COVID-intubation risk score-neutrophil/lymphocyte ratio (IRS-NLR), inflammation-based score, and ventilation in COVID estimator (VICE) score. Methods The medical records of all patients hospitalized for a laboratory-confirmed COVID-19 diagnosis between May 2021 and June 2021 were retrospectively analyzed. Data were extracted within the first 24 h of admission, and five different scores were calculated. The primary and secondary outcomes were 30-day mortality and mechanical ventilation, respectively. Results A total of 285 patients were enrolled in our cohort. Sixty-five patients (22.8%) were intubated with ventilator support, and the 30-day mortality rate was 8.8%. The Shang COVID severity score had the highest numerical area under the receiver operator characteristic (AUC-ROC) (AUC 0.836) curve to predict 30-day mortality, followed by the SEIMC score (AUC 0.807) and VICE score (AUC 0.804). For intubation, both the VICE and COVID-IRS-NLR scores had the highest AUC (AUC 0.82) compared to the inflammation-based score (AUC 0.69). The 30-day mortality increased steadily according to higher Shang COVID severity scores and SEIMC scores. The intubation rate exceeded 50% in the patients stratified by higher VICE scores and COVID-IRS-NLR score quintiles. Conclusion The discriminative performances of the SEIMC score and Shang COVID severity score are good for predicting the 30-day mortality of hospitalized COVID-19 patients. The COVID-IRS-NLR and VICE showed good performance for predicting invasive mechanical ventilation (IMV).
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Affiliation(s)
- Hsin-Pei Chung
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Hsiang Tang
- Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Chun-Yen Chen
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chao-Hsien Chen
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wen-Kuei Chang
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Kuan-Chih Kuo
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Ting Chen
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Jou-Chun Wu
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chang-Yi Lin
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chieh-Jen Wang
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan,Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan,*Correspondence: Chieh-Jen Wang,
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An H, Zhang J, Li T, Hu Y, Wang Q, Chen C, Ying B, Jin S, Li M. Inflammation/Coagulopathy/Immunology Responsive Index Predicts Poor COVID-19 Prognosis. Front Cell Infect Microbiol 2022; 12:807332. [PMID: 35310845 PMCID: PMC8930906 DOI: 10.3389/fcimb.2022.807332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/08/2022] [Indexed: 01/08/2023] Open
Abstract
In the early stage of coronavirus disease 2019 (COVID-19), most cases are identified as mild or moderate illnesses. Approximately 20% of hospitalised patients become severe or critical at the middle or late stage of the disease. The predictors and risk factors for prognosis in those with mild or moderate disease remain to be determined. Of 694 patients with COVID-19, 231 patients with mild or moderate disease, who were hospitalised at 10 hospitals in Wenzhou and nearby counties in China, were enrolled in this retrospective study from 17 January to 20 March 2020. The outcomes of these patients included progression from mild/moderate illness to severe or critical conditions. Among the 231 patients, 49 (21.2%) had a poor prognosis in the hospital. Multivariate logistic regression analysis showed that higher inflammation/coagulopathy/immunology responsive index (ICIRI=[c-reactive protein × fibrinogen × D-dimer]/CD8 T cell count) on admission (OR=345.151, 95% CI=23.014−5176.318) was associated with increased odds ratios for poor prognosis. The area under the receiver operating characteristic curve for ICIRI predicting severe and critical condition progression was 0.65 (95% CI=0.519−0.782) and 0.80 (95% CI=0.647−0.954), with cut-off values of 870.83 and 535.44, respectively. Conversely, age, sex, comorbidity, neutrophil/lymphocyte ratio, CD8 T cell count, and c-reactive protein, fibrinogen, and D-dimer levels alone at admission were not good predictors of poor prognosis in patients with mild or moderate COVID-19. At admission, a novel index, ICIRI, tends to be the most promising predictor of COVID-19 progression from mild or moderate illness to severe or critical conditions.
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Affiliation(s)
- Hui An
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China
| | - Jitai Zhang
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China
| | - Ting Li
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Yuxin Hu
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China
| | - Qian Wang
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China
| | - Chengshui Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Binyu Ying
- Department of Critical Care Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shengwei Jin
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China
| | - Ming Li
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China
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