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West AC, Harpur CM, Le Page MA, Lam M, Hodges C, Ely LK, Gearing AJ, Tate MD. Harnessing Endogenous Peptide Compounds as Potential Therapeutics for Severe Influenza. J Infect Dis 2024; 230:e384-e394. [PMID: 38060822 PMCID: PMC11326819 DOI: 10.1093/infdis/jiad566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/05/2023] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Excessive pulmonary inflammation and damage are characteristic features of severe influenza virus infections. LAT8881 is a synthetic 16-amino acid cyclic peptide form of a naturally occurring C-terminal fragment of human growth hormone with therapeutic efficacy against influenza. Shorter linear peptides are typically easier to manufacture and formulate for delivery than larger cyclic peptides. A 6-amino acid linear peptide fragment of LAT8881, LAT9997, was investigated as a potential influenza therapy. METHODS LAT9997 was evaluated for its potential to limit disease in a preclinical mouse model of severe influenza infection. RESULTS Intranasal treatment of mice with either LAT8881 or LAT9997 from day 1 following influenza infection significantly improved survival outcomes. Initiating LAT9997 treatment at the onset of severe disease also significantly improved disease severity. Greater disease resistance in LAT9997-treated mice correlated with reduced lung immunopathology, damage markers, vascular leak, and epithelial cell death. Treatment reduced viral loads, cytokines, and neutrophil infiltration in the airways yet maintained protective alveolar macrophages in a dose-dependent manner. Sequential trimming of N- and C-terminal amino acids from LAT9997 revealed a structure-activity relationship. CONCLUSIONS These findings provide preclinical evidence that therapeutic LAT9997 treatment limits viral burden and characteristic features of severe influenza, including hyperinflammation and lung damage. SUMMARY Excessive pulmonary inflammation and damage are characteristic features of severe influenza virus infections. LAT9997 is a linear peptide fragment derived from human growth hormone. This study provides preclinical evidence that therapeutic LAT9997 treatment limits viral burden, hyperinflammation, and lung damage.
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Affiliation(s)
- Alison C West
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research
- Department of Molecular and Translational Sciences, Monash University, Clayton
| | - Christopher M Harpur
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research
- Department of Molecular and Translational Sciences, Monash University, Clayton
| | - Mélanie A Le Page
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research
- Department of Molecular and Translational Sciences, Monash University, Clayton
| | - Maggie Lam
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research
- Department of Molecular and Translational Sciences, Monash University, Clayton
| | - Christopher Hodges
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research
- Department of Molecular and Translational Sciences, Monash University, Clayton
| | | | | | - Michelle D Tate
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research
- Department of Molecular and Translational Sciences, Monash University, Clayton
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2
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Shen W, Liu C, Hu Y, Lei Y, Wong HS, Wu S, Zhou XM. Leveraging cross-source heterogeneity to improve the performance of bulk gene expression deconvolution. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.07.588458. [PMID: 38645128 PMCID: PMC11030304 DOI: 10.1101/2024.04.07.588458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
A main limitation of bulk transcriptomic technologies is that individual measurements normally contain contributions from multiple cell populations, impeding the identification of cellular heterogeneity within diseased tissues. To extract cellular insights from existing large cohorts of bulk transcriptomic data, we present CSsingle, a novel method designed to accurately deconvolve bulk data into a predefined set of cell types using a scRNA-seq reference. Through comprehensive benchmark evaluations and analyses using diverse real data sets, we reveal the systematic bias inherent in existing methods, stemming from differences in cell size or library size. Our extensive experiments demonstrate that CSsingle exhibits superior accuracy and robustness compared to leading methods, particularly when dealing with bulk mixtures originating from cell types of markedly different cell sizes, as well as when handling bulk and single-cell reference data obtained from diverse sources. Our work provides an efficient and robust methodology for the integrated analysis of bulk and scRNA-seq data, facilitating various biological and clinical studies.
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Affiliation(s)
- Wenjun Shen
- Department of Bioinformatics, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Cheng Liu
- Department of Computer Science, Shantou University, Shantou, Guangdong 515041, China
| | - Yunfei Hu
- Department of Computer Science, Vanderbilt University, Nashville, TN 37235, USA
| | - Yuanfang Lei
- Department of Bioinformatics, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Hau-San Wong
- Department of Computer Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Si Wu
- Department of Computer Science, South China University of Technology, Guangzhou, Guangdong 510006, China
| | - Xin Maizie Zhou
- Department of Computer Science, Vanderbilt University, Nashville, TN 37235, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
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3
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Wei-Wen Hsiao W, Fadhilah G, Lee CC, Endo R, Lin YJ, Angela S, Ku CC, Chang HC, Chiang WH. Nanomaterial-based biosensors for avian influenza virus: A new way forward. Talanta 2023; 265:124892. [PMID: 37451119 DOI: 10.1016/j.talanta.2023.124892] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
Avian influenza virus (AIV) is a zoonotic virus that can be transmitted from animals to humans. Although human infections are rare, the virus has a high mortality rate when contracted. Appropriate detection methods are thus crucial for combatting this pathogen. There is a growing demand for rapid, selective, and accurate methods of identifying the virus. Numerous biosensors have been designed and commercialized to detect AIV. However, they all have considerable shortcomings. Nanotechnology offers a new way forward. Nanomaterials produce more eco-friendly, rapid, and portable diagnostic systems. They also exhibit high sensitivity and selectivity while achieving a low detection limit (LOD). This paper reviews state-of-the-art nanomaterial-based biosensors for AIV detection, such as those composed of quantum dots, gold, silver, carbon, silica, nanodiamond, and other nanoparticles. It also offers insight into potential trial protocols for creating more effective methods of identifying AIV and discusses key issues associated with developing nanomaterial-based biosensors.
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Affiliation(s)
- Wesley Wei-Wen Hsiao
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan.
| | - Gianna Fadhilah
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan
| | - Cheng-Chung Lee
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, 11031, Taiwan
| | - Ryu Endo
- Department of Biomedical Engineering, The Ohio State University, 43210, USA
| | - Yu-Jou Lin
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan
| | - Stefanny Angela
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan
| | - Chia-Chi Ku
- Graduate Institute of Immunology, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan
| | - Huan-Cheng Chang
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan; Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei, 106319, Taiwan
| | - Wei-Hung Chiang
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan.
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4
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Shusterman E, Prozan L, Ablin JN, Weiss-Meilik A, Adler A, Choshen G, Kehat O. Neutrophil-to-lymphocyte ratio trend at admission predicts adverse outcome in hospitalized respiratory syncytial virus patients. Heliyon 2023; 9:e16482. [PMID: 37251466 PMCID: PMC10220360 DOI: 10.1016/j.heliyon.2023.e16482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 03/31/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
Background and aims Severe cases of respiratory syncytial virus (RSV) infection are relatively rare but may lead to serious clinical outcomes, including respiratory failure and death. These infections were shown to be accompanied by immune dysregulation. We aimed to test whether the admission neutrophil-to-leukocyte ratio, a marker of an aberrant immune response, can predict adverse outcome. Methods We retrospectively analyzed a cohort of RSV patients admitted to the Tel Aviv Medical Center from January 2010 to October 2020d. Laboratory, demographic and clinical parameters were collected. Two-way analysis of variance was used to test the association between neutrophil-lymphocyte ratio (NLR) values and poor outcomes. Receiver operating characteristic (ROC) curve analysis was applied to test the discrimination ability of NLR. Results In total, 482 RSV patients (median age 79 years, 248 [51%] females) were enrolled. There was a significant interaction between a poor clinical outcome and a sequential rise in NLR levels (positive delta NLR). The ROC curve analysis revealed an area under curve (AUC) of poor outcomes for delta NLR of (0.58). Using a cut-off of delta = 0 (the second NLR is equal to the first NLR value), multivariate logistic regression identified a rise in NLR (delta NLR>0) as being a prognostic factor for poor clinical outcome, after adjusting for age, sex and Charlson comorbidity score, with an odds ratio of 1.914 (P = 0.014) and a total AUC of 0.63. Conclusions A rise in NLR levels within the first 48 h of hospital admission can serve as a prognostic marker for adverse outcome.
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Affiliation(s)
- Eden Shusterman
- Internal Medicine H, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
| | - Lior Prozan
- Internal Medicine H, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
| | - Jacob Nadav Ablin
- Internal Medicine H, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Amos Adler
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
| | - Guy Choshen
- Internal Medicine H, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
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Abeid ST, Mezedawee AAS, Alam YSJ. EXPLORING THE INFLUENCE OF NEUTROPHIL-LYMPHOCYTE RATIO ON OUTCOME PREDICTION OF SEVERELY-ILL PATIENTS WITH COVID-19. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 75:2926-2932. [PMID: 36723305 DOI: 10.36740/wlek202212106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim: The study conducted to have a better understanding on the role of neutrophil-lymphocyte ratio in the determination of the prognosis of COVID-19 and to assist in predicting disease severity. PATIENTS AND METHODS Materials and methods: A total of 96 patients within age group 18-80 years who were verified positive for the COVID-19 by PCR, and admitted to (Al-Sader Medical City) in Al-Najaf City between (July to October 2020) were enrolled in a cohort retrospective study, Neutrophil to lymphocyte ratio was calculated via taking the absolute neutrophil count divided by the absolute lymphocyte count. Other parameters like (renal function tests, D-dimer, C-reactive protein, serum ferritin) also has been studied in relation to outcome of patients with COVID-19. RESULTS Results: The Neutrophil-lymphocyte ratio was significantly associated with low oxygen saturation and poor outcome. A significant difference was found between two clusters in CRP, serum ferritin, and D-dimer level. In addition, age and obstructive airway disease were important clinical predictors for poor outcome. CONCLUSION Conclusions: The study was a useful prognostic marker linked with poor outcome in patients admitted for COVID-19 pneumonia. Other inflammatory markers, such as ferritin, CRP, and D-dimer were also associated with critical illness and increased mortality from COVID-19 disease.
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Affiliation(s)
- Samir Taha Abeid
- DEPARTMENT OF MEDICINE, COLLEGE OF MEDICINE, UNIVERSITY OF KUFA, NAJAF, IRAQ
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6
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Jheng JC, Tseng YT, Wang TH, Chen LF, Chung JY. Using neutrophil to lymphocyte ratio to predict discharge among geriatric patients with influenza infection in emergency department. Medicine (Baltimore) 2022; 101:e30261. [PMID: 36042631 PMCID: PMC9410611 DOI: 10.1097/md.0000000000030261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022] Open
Abstract
The neutrophil-to-lymphocyte ratio (NLR) is used to predict the prognosis of various diseases, such as coronavirus disease 2019, community-acquired pneumonia, bacteremia, and endocarditis. However, NLR has never been reported to predict patient discharge in geriatric patients with influenza infection. This retrospective case-control study enrolled geriatric patients (≥65 years) with influenza virus infection who visited the emergency department of a medical center between January 01, 2010 and December 31, 2015. Demographic data, vital signs, past histories, influenza subtypes, outcomes, and disposition were analyzed. The optimal NLR cut-off value to predict patient discharge was determined using the Youden index. We also evaluated the accuracy of NLR in predicting patient discharge using logistic regression and receiver operating characteristic analysis. The study included 409 geriatric patients in the emergency department with a mean age of 79.5 years and an approximately equal sex ratio. NLR was significantly lower in the discharged group than in the nondischarged group (5.8 ± 3.7 vs 9.7 ± 8.4). Logistic regression revealed that patients with NLR ≤ 6.5 predicted discharge with an odds ratio of 3.62. The Hosmer-Lemeshow goodness-of-fit test was calculated as 0.36, and the adjusted area under the receiver operating characteristic was 0.75. The negative predictive value of NLR ≤ 6.5, to predict patient discharge, was 91.8%. NLR ≤ 6.5 is a simple and easy-to-obtain laboratory tool to guide the physicians to discharge geriatric patients with influenza infection in the crowded emergency department.
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Affiliation(s)
- Jing-Cheng Jheng
- Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan, Taiwan
| | - Yen-Ting Tseng
- Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan, Taiwan
| | - Te-Hao Wang
- Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan, Taiwan
| | - Li-Fu Chen
- Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jui-Yuan Chung
- Department of Emergency Medicine, Cathay General Hospital, Taipei, Taiwan
- School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
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7
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Yeh JJ, Lai M, Lin CL, Lu KH, Kao CH. Effects of statins on the risks of ischemic stroke and heart disease in human immunodeficiency virus infection, influenza and severe acute respiratory syndrome-associated coronavirus: respiratory virus infection with steroid use. Postgrad Med 2022; 134:589-597. [PMID: 35590450 DOI: 10.1080/00325481.2022.2080359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We sought to fill the research gap on the effects of statins on the risks of ischemic stroke and heart disease among individuals with human immunodeficiency virus infection, influenza, and severe acute respiratory syndrome associated-coronavirus (HIS) disorders. METHODS We enrolled a HIS cohort treated with statins (n = 4921) and a HIS cohort not treated with statins (n = 4921). The cumulative incidence of ischemic stroke and heart disease was analyzed using a time-dependent Cox proportional regression analysis. We analyzed the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of ischemic stroke and heart disease for statins users relative to nonusers based on sex, age, comorbidities and medications. RESULTS The aHR (95% CI) was 0.38 (0.22-0.65) for ischemic stroke. The aHR (95% CI) of heart disease was 0.50 (0.46-0.55). The aHRs (95% CI) of statin users with low, medium, and high adherence (statin use covering <33%, 33%-66%, and >66%, respectively, of the study period) for the risks of ischemic stroke were 0.50 (0.27-0.92), 0.31 (0.10-1.01), and 0.16 (0.04-0.68) and for heart disease were 0.56 (0.51-0.61), 0.40 (0.33-0.48), and 0.44 (0.38-0.51), respectively, compared with statin nonusers. CONCLUSION Statin use was associated with lower aHRs for ischemic stroke and heart disease in those with HIS disorders with comorbidities.
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Affiliation(s)
- Jun-Jun Yeh
- Department of Family Medicine, Geriatric Medicine, and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Meichu Lai
- Department of Laboratory Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Hua Lu
- Department of Family Medicine, Geriatric Medicine, and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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8
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Ketenci S, Saraçoğlu İ, Duranay R, Elgörmüş ÇS, Aynacıoğlu AŞ. Retrospective analysis of biochemical markers in COVID-19 intensive care unit patients. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2022. [PMCID: PMC9100315 DOI: 10.1186/s43168-022-00129-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background The aim of the study was to evaluate the presence and effects of hematological and biological parameters in the diagnosis of the disease by performing blood tests on COVID-19 patients admitted to the intensive care unit (ICU). Results Biochemical parameters from the blood samples of 279 patients who were confirmed to have COVID-19 and met the criteria for admission to the ICU were compared between discharged and deceased patients. Multiple logistic regression analysis was performed in terms of mortality and probability of being discharged. The predictive value of serum C-reactive protein (CRP), procalcitonin (PCT), lymphocyte, neutrophil, leucocyte, and platelet (PLT) levels was evaluated by measuring the area under the receiver operating characteristic curve (AUROC). Comparisons made according to deceased and survival patients results revealed that while no statistically significant difference was observed between test groups lymphocyte and platelet-lymphocyte ratio values, statistically significant difference was found between the test groups regarding platelet, leukocyte, neutrophil, PCT, neutrophil-lymphocyte ratio (NLR), and thrombocyte count × neutrophil count/lymphocyte count (SII) values. Conclusions This study showed that biochemical parameters examined are important in determining the prognosis of the disease and may be useful in determining the direction of the treatment process and predicting the risk of discharge or death after the initial evaluation of the patients in the ICU.
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Gleason J, Zhao Y, Raitman I, Kang L, He S, Hariri R. Human placental hematopoietic stem cell derived natural killer cells (CYNK-001) mediate protection against influenza a viral infection. Hum Vaccin Immunother 2022; 18:2055945. [PMID: 35404743 PMCID: PMC9255201 DOI: 10.1080/21645515.2022.2055945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Influenza A virus (IAV) infections are associated with a high healthcare burden around the world and there is an urgent need to develop more effective therapies. Natural killer (NK) cells have been shown to play a pivotal role in reducing IAV-induced pulmonary infections in preclinical models; however, little is known about the therapeutic potential of adoptively transferred NK cells for IAV infections. Here, we investigated the effects of CYNK-001, human placental hematopoietic stem cell derived NK cells that exhibited strong cytolytic activity against a range of malignant cells and expressed high levels of activating receptors, against IAV infections. In a severe IAV-induced acute lung injury model, mice treated with CYNK-001 showed a milder body weight loss and clinical symptoms, which led to a delayed onset of mortality, thus demonstrating their antiviral protection in vivo. Analysis of bronchoalveolar lavage fluid (BALF) revealed that CYNK-001 reduced proinflammatory cytokines and chemokines highlighting CYNK-001’s anti-inflammatory actions in viral induced-lung injury. Furthermore, CYNK-001-treated mice had altered immune responses to IAV with reduced number of neutrophils in BALF yet increased number of CD8+ T cells in the BALF and lung compared to vehicle-treated mice. Our results demonstrate that CYNK-001 displays protective functions against IAV via its anti-inflammatory and immunomodulating activities, which leads to alleviation of disease burden and progression in a severe IAV-infected mice model. The potential of adoptive NK therapy for IAV infections warrants clinical investigation.
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Affiliation(s)
| | - Yuechao Zhao
- Celularity Inc., Florham Park, New Jersey, NJ, USA
| | | | - Lin Kang
- Celularity Inc., Florham Park, New Jersey, NJ, USA
| | - Shuyang He
- Celularity Inc., Florham Park, New Jersey, NJ, USA
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10
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Wang G, Lv C, Liu C, Shen W. Neutrophil-to-lymphocyte ratio as a potential biomarker in predicting influenza susceptibility. Front Microbiol 2022; 13:1003380. [PMID: 36274727 PMCID: PMC9583527 DOI: 10.3389/fmicb.2022.1003380] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Human population exposed to influenza viruses exhibited wide variation in susceptibility. The ratio of neutrophils to lymphocytes (NLR) has been examined to be a marker of systemic inflammation. We sought to investigate the relationship between influenza susceptibility and the NLR taken before influenza virus infection. METHODS We investigated blood samples from five independent influenza challenge cohorts prior to influenza inoculation at the cellular level by using digital cytometry. We used multi-cohort gene expression analysis to compare the NLR between the symptomatic infected (SI) and asymptomatic uninfected (AU) subjects. We then used a network analysis approach to identify host factors associated with NLR and influenza susceptibility. RESULTS The baseline NLR was significantly higher in the SI group in both discovery and validation cohorts. The NLR achieved an AUC of 0.724 on the H3N2 data, and 0.736 on the H1N1 data in predicting influenza susceptibility. We identified four key modules that were not only significantly correlated with the baseline NLR, but also differentially expressed between the SI and AU groups. Genes within these four modules were enriched in pathways involved in B cell-mediated immune responses, cellular metabolism, cell cycle, and signal transduction, respectively. CONCLUSIONS This study identified the NLR as a potential biomarker for predicting disease susceptibility to symptomatic influenza. An elevated NLR was detected in susceptible hosts, who may have defects in B cell-mediated immunity or impaired function in cellular metabolism, cell cycle or signal transduction. Our work can serve as a comparative model to provide insights into the COVID-19 susceptibility.
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Affiliation(s)
- Guoyun Wang
- Department of Bioinformatics, Shantou University Medical College, Shantou, China
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Cheng Lv
- Department of Bioinformatics, Shantou University Medical College, Shantou, China
| | - Cheng Liu
- Department of Computer Science, Shantou University, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, China
| | - Wenjun Shen
- Department of Bioinformatics, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, China
- *Correspondence: Wenjun Shen
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11
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Kong J, Hao Y, Wan S, Li Z, Zou D, Zhang L, Lu Y, Wang J, Chen X, Fu J. Comparative study of hematological and radiological feature of severe/critically ill patients with COVID-19, influenza A H7N9, and H1N1 pneumonia. J Clin Lab Anal 2021; 35:e24100. [PMID: 34762754 PMCID: PMC8646601 DOI: 10.1002/jcla.24100] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study aimed to explore clinical indexes for management of severe/critically ill patients with COVID-19, influenza A H7N9, and H1N1 pneumonia by comparing hematological and radiological characteristics. METHODS Severe/critically ill patients with COVID-19, H7N9, and H1N1 pneumonia were retrospectively enrolled. The demographic data, clinical manifestations, hematological parameters, and radiological characteristics were compared. RESULTS In this study, 16 cases of COVID-19, 10 cases of H7N9, and 13 cases of H1N1 who met severe/critically ill criteria were included. Compared with COVID-19, H7N9 and H1N1 groups had more chronic diseases (80% and 92.3% vs. 25%, p < 0.05), higher APACHE Ⅱ scores (16.00 ± 8.63 and 15.08 ± 6.24, vs. 5.50 ± 2.58, p < 0.05), higher mortality rates (40% and 46.2% vs. 0%, p < 0.05), significant lymphocytopenia (0.59 ± 0.31 × 109 /L and 0.56 ± 0.35 × 109 /L vs. 0.97 ± 0.33 × 109 /L, p < 0.05), and elevated neutrophil-to-lymphocyte ratio (NLR; 14.67 ± 6.10 and 14.64 ± 10.36 vs. 6.29 ± 3.72, p < 0.05). Compared with the H7N9 group, ground-glass opacity (GGO) on chest CT was common in the COVID-19 group (p = 0.028), while pleural effusion was rare (p = 0.001). CONCLUSIONS The NLR can be used as a clinical parameter for the predication of risk stratification and outcome in COVID-19 and influenza A pneumonia. Manifestations of pleural effusion or GGO in chest CT may be helpful for the identification of different viral pneumonia.
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Affiliation(s)
- Jindan Kong
- Department of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China.,Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan Hao
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shan Wan
- Department of Pathology, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, China
| | - Zheng Li
- Department of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Di Zou
- Department of Critical Care Medicine, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, China
| | - Leisi Zhang
- Department of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Yin Lu
- Department of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Jun Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaochen Chen
- Department of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Jianhong Fu
- Department of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
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12
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Prozan L, Shusterman E, Ablin J, Mitelpunkt A, Weiss-Meilik A, Adler A, Choshen G, Kehat O. Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 compared with Influenza and respiratory syncytial virus infection. Sci Rep 2021; 11:21519. [PMID: 34728719 PMCID: PMC8563769 DOI: 10.1038/s41598-021-00927-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 10/14/2021] [Indexed: 12/11/2022] Open
Abstract
A high neutrophil to lymphocyte ratio (NLR) is considered an unfavorable prognostic factor in various diseases, including COVID-19. The prognostic value of NLR in other respiratory viral infections, such as Influenza, has not hitherto been extensively studied. We aimed to compare the prognostic value of NLR in COVID-19, Influenza and Respiratory Syncytial Virus infection (RSV). A retrospective cohort of COVID-19, Influenza and RSV patients admitted to the Tel Aviv Medical Center from January 2010 to October 2020 was analyzed. Laboratory, demographic, and clinical parameters were collected. Two way analyses of variance (ANOVA) was used to compare the association between NLR values and poor outcomes among the three groups. ROC curve analyses for each virus was applied to test the discrimination ability of NLR. 722 COVID-19, 2213 influenza and 482 RSV patients were included. Above the age of 50, NLR at admission was significantly lower among COVID-19 patients (P < 0.001). NLR was associated with poor clinical outcome only in the COVID-19 group. ROC curve analysis was performed; the area under curve of poor outcomes for COVID-19 was 0.68, compared with 0.57 and 0.58 for Influenza and RSV respectively. In the COVID-19 group, multivariate logistic regression identified a high NLR (defined as a value above 6.82) to be a prognostic factor for poor clinical outcome, after adjusting for age, sex and Charlson comorbidity score (odds ratio of 2.9, P < 0.001). NLR at admission is lower and has more prognostic value in COVID-19 patients, when compared to Influenza and RSV.
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Affiliation(s)
- Lior Prozan
- Department of Internal Medicine H, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel.
| | - Eden Shusterman
- Department of Internal Medicine H, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Jacob Ablin
- Department of Internal Medicine H, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Alexis Mitelpunkt
- I-Medata AI Center, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
- Pediatric Rehabilitation Service, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Ahuva Weiss-Meilik
- I-Medata AI Center, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Amos Adler
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
- Microbiology Laboratory, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Guy Choshen
- Department of Internal Medicine H, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
- Infectious Diseases Unit, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Orli Kehat
- I-Medata AI Center, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
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13
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Örün S, Erdem MN. Contribution of neutrophil/lymphocyte ratio to the diagnostic efficiency of computed tomography and polymerase chain reaction in COVID-19 patients. SAGE Open Med 2021; 9:20503121211046416. [PMID: 34552748 PMCID: PMC8450615 DOI: 10.1177/20503121211046416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/26/2021] [Indexed: 01/08/2023] Open
Abstract
Background: 6.5% of the country’s population was diagnosed with COVID-19 disease. Computed tomography scanning and polymerase chain reaction tests are considered reliable methods for the detection of COVID-19. However, the specificity and reliability of polymerase chain reaction tests and ground-glass opacity (GGO) on thorax computed tomography images in diagnosing COVID-19 are still being disputed. Our aim was to compare the neutrophil/lymphocyte ratio, whose efficiency in differentiating between viral and bacterial infections has previously been studied, with computed tomography and polymerase chain reaction for COVID-19 diagnosis. Materials and methods: This was a retrospective study that included patients treated in a tertiary care hospital emergency service pandemic polyclinic between 14 March and 1 June 2020. The neutrophil/lymphocyte ratios of patients with polymerase chain reaction tests and ground-glass opacities on computed tomography were calculated. The neutrophil/lymphocyte ratios of polymerase chain reaction-negative patients with computed tomography images were compared with the neutrophil/lymphocyte ratios of polymerase chain reaction-positive patients with computed tomography images. Results: A total of 631 patients were included in this study. Thorax computed tomography scans were obtained from all patients. The mean neutrophil/lymphocyte ratio of patients with ground-glass opacities was 3.50 ± 2.12, whereas that of patients without ground-glass opacities was 2.90 ± 2.01. This difference was also statistically significant. Polymerase chain reaction swab samples were obtained from 282 patients (44.7%). The mean neutrophil/lymphocyte ratio of polymerase chain reaction-positive patients was 2.38 ± 1.02, whereas that of polymerase chain reaction-negative patients was 3.97 ± 2.25. The difference was statistically significant. Conclusion: Many studies are undoubtedly required to determine the efficiency of the neutrophil/lymphocyte ratio in COVID-19 diagnosis. However, we postulate that evaluating the neutrophil/lymphocyte ratio along with computed tomography and polymerase chain reaction can assist in the diagnosis of patients.
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Affiliation(s)
- Serhat Örün
- Faculty of Medicine, Namik Kemal University, Tekirdağ, Turkey
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14
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Morris G, Bortolasci CC, Puri BK, Marx W, O'Neil A, Athan E, Walder K, Berk M, Olive L, Carvalho AF, Maes M. The cytokine storms of COVID-19, H1N1 influenza, CRS and MAS compared. Can one sized treatment fit all? Cytokine 2021; 144:155593. [PMID: 34074585 PMCID: PMC8149193 DOI: 10.1016/j.cyto.2021.155593] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/03/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023]
Abstract
An analysis of published data appertaining to the cytokine storms of COVID-19, H1N1 influenza, cytokine release syndrome (CRS), and macrophage activation syndrome (MAS) reveals many common immunological and biochemical abnormalities. These include evidence of a hyperactive coagulation system with elevated D-dimer and ferritin levels, disseminated intravascular coagulopathy (DIC) and microthrombi coupled with an activated and highly permeable vascular endothelium. Common immune abnormalities include progressive hypercytokinemia with elevated levels of TNF-α, interleukin (IL)-6, and IL-1β, proinflammatory chemokines, activated macrophages and increased levels of nuclear factor kappa beta (NFκB). Inflammasome activation and release of damage associated molecular patterns (DAMPs) is common to COVID-19, H1N1, and MAS but does not appear to be a feature of CRS. Elevated levels of IL-18 are detected in patients with COVID-19 and MAS but have not been reported in patients with H1N1 influenza and CRS. Elevated interferon-γ is common to H1N1, MAS, and CRS but levels of this molecule appear to be depressed in patients with COVID-19. CD4+ T, CD8+ and NK lymphocytes are involved in the pathophysiology of CRS, MAS, and possibly H1N1 but are reduced in number and dysfunctional in COVID-19. Additional elements underpinning the pathophysiology of cytokine storms include Inflammasome activity and DAMPs. Treatment with anakinra may theoretically offer an avenue to positively manipulate the range of biochemical and immune abnormalities reported in COVID-19 and thought to underpin the pathophysiology of cytokine storms beyond those manipulated via the use of, canakinumab, Jak inhibitors or tocilizumab. Thus, despite the relative success of tocilizumab in reducing mortality in COVID-19 patients already on dexamethasone and promising results with Baricitinib, the combination of anakinra in combination with dexamethasone offers the theoretical prospect of further improvements in patient survival. However, there is currently an absence of trial of evidence in favour or contravening this proposition. Accordingly, a large well powered blinded prospective randomised controlled trial (RCT) to test this hypothesis is recommended.
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Affiliation(s)
- Gerwyn Morris
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Chiara C Bortolasci
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Deakin University, Centre for Molecular and Medical Research, School of Medicine, Geelong, Australia
| | | | - Wolfgang Marx
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Melbourne School of Population and Global Health, Melbourne, Australi
| | - Eugene Athan
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Barwon Health, Geelong, Australia
| | - Ken Walder
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Deakin University, Centre for Molecular and Medical Research, School of Medicine, Geelong, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Lisa Olive
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Deakin University, School of Psychology, Geelong, Australia
| | - Andre F Carvalho
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, University of Toronto, Toronto, Canada, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Michael Maes
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, King Chulalongkorn University Hospital, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
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15
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Yu X, Cai T, Fan L, Liang Z, Du Q, Wang Q, Yang Z, Vlahos R, Wu L, Lin L. The traditional herbal formulation, Jianpiyifei II, reduces pulmonary inflammation induced by influenza A virus and cigarette smoke in mice. Clin Sci (Lond) 2021; 135:1733-1750. [PMID: 34236078 DOI: 10.1042/cs20210050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a worldwide chronic inflammatory lung disease, and influenza A virus (IAV) infection is a common cause of acute exacerbations of COPD (AECOPD). Therefore, targeting viral infections represents a promising strategy to prevent the occurrence and development of inflammatory flare ups in AECOPD. Jianpiyifei II (JPYFII) is a traditional herbal medicine used in China to treat patients with COPD, and its clinical indications are not well understood. However, investigation of the anti-inflammatory effects and underlying mechanism using an animal model of smoking have been reported in a previous study by our group. In addition, some included herbs, such as Radix astragali and Radix aupleuri, were reported to exhibit antiviral effects. Therefore, the aim of the present study was to investigate whether JPYFII formulation relieved acute inflammation by clearing the IAV in a mouse model that was exposed to cigarette smoke experimentally. JPYFII formulation treatment during smoke exposure and IAV infection significantly reduced the number of cells observed in bronchoalveolar lavage fluid (BALF), expression of proinflammatory cytokines, chemokines, superoxide production, and viral load in IAV-infected and smoke-exposed mice. However, JPYFII formulation treatment during smoke exposure alone did not reduce the number of cells in BALF or the expression of Il-6, Tnf-a, and Il-1β. The results demonstrated that JPYFII formulation exerted an antiviral effect and reduced the exacerbation of lung inflammation in cigarette smoke (CS)-exposed mice infected with IAV. Our results suggested that JPYFII formulation could potentially be used to treat patients with AECOPD associated with IAV infection.
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Affiliation(s)
- Xuhua Yu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Tiantian Cai
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Long Fan
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Ziyao Liang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qiuling Du
- Guangdong Key laboratory of Clinical Molecular Medicine and Diagnostics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510180, China
| | - Qi Wang
- Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Zifeng Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510180, China
| | - Ross Vlahos
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Lei Wu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Lin Lin
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
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16
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Fu S, Zhang MM, Zhang L, Wu LF, Hu QL. The Value of Combined Serum Amyloid A Protein and Neutrophil-to-Lymphocyte Ratio Testing in the Diagnosis and Treatment of Influenza A in Children. Int J Gen Med 2021; 14:3729-3735. [PMID: 34326659 PMCID: PMC8314685 DOI: 10.2147/ijgm.s313895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this study was to explore the value of serum amyloid A protein (SAA) and neutrophil-to-lymphocyte ratio (NLR) testing in the diagnosis and treatment of children with influenza A. Methods Specimens were collected from 85 children with influenza A, 85 children with a bacterial infection, and 86 healthy children. The levels of SAA and C-reactive protein (CRP) were measured, and routine blood tests were performed. Results The levels of SAA and CRP in the bacterial infection group were significantly higher than those in the influenza A group, and the levels in the influenza A group were higher than those in the healthy children. The NLR level in the influenza A group was not different from that in the bacterial infection group, but the NLR levels in the influenza A group and the bacterial infection group were higher than that in the healthy controls. The number of white blood cell (WBC) in the influenza A group was not different from that in healthy children, while the WBC counts in the control and bacterial infection groups were higher than that in the influenza A group. The distribution width of red blood cells in the bacterial infection group was higher than that in healthy controls. The receiver operating characteristic curve analysis showed that the area under the curve for the diagnoses of influenza A for SAA, NLR, and CRP was 0.806, 0.768, and 0.699, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SAA/NLR (SAA and NLR in the series) were 68.24%/76.47% (57.65%), 84.88%/72.09% (96.76%), 81.69%/73.03% (96.08%), 73.00%/75.61% (70.00%), and 76.61%/74.27% (77.78%), respectively. Conclusion In the early diagnosis of children with influenza A, the values of SAA and NLR are high. Thus, they could be used for monitoring and efficacy evaluation during the course of the disease.
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Affiliation(s)
- Shui Fu
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Miao-Miao Zhang
- Department of Emergency, The Fifth People's Hospital of Yuhang District, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Liang Zhang
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Li-Feng Wu
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Qi-Lei Hu
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, 311100, People's Republic of China
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17
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Li X, Cai Q, Jia Z, Zhou Y, Liu L, Zhou Y, Zhang B, Ren L, Tang Y. The correlation between mental health status, sleep quality, and inflammatory markers, virus negative conversion time among patients confirmed with 2019-nCoV during the COVID-19 outbreak in China: An observational study. Medicine (Baltimore) 2021; 100:e26520. [PMID: 34232185 PMCID: PMC8270605 DOI: 10.1097/md.0000000000026520] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023] Open
Abstract
The 2019 coronavirus disease (COVID-19) has spread to the whole world. Psychological and sleep problems among confirmed patients have drawn extensive attention which may be highly related to immune function and inflammatory responses of people. The aim of this study is to examine the correlation of mental health status, sleep quality, and inflammatory markers, virus negative conversion time (NCT) among confirmed patients during the COVID-19 outbreak.A cross-sectional survey was conducted in this study. Data from 66 patients assessed with demographic information, anxious symptom, depressive symptom, stress, and sleep quality were collected using a smartphone-based questionnaire platform and then clinical characteristics and laboratory indicators were collected using case review.Nearly 30% of the participants reported depression, anxiety, perceived pressure, and poor sleep quality. Compared with the group without depression, neutrophil count, and ratio of neutrophil count to lymphocyte count (NLR) in the depression disorder group were increased (P = .028, 0.043). There was also a significant difference in NLR and NCT between the anxiety group and the non-anxiety group (P = .021, .024). Similarly, compared with the good sleep quality group, NLR in the poor sleep quality group was increased (P = .011). Correlation analysis indicated that Self-Rating Depression Scale score was positively related to neutrophil count and NLR (r = 0.366, 0.330, P = .016, .031). The total score of Pittsburgh Sleep Quality Index (PSQI) was negatively related to lymphocyte count (r = -0.317, P = .049), and the sleep disturbance as 1 of the 7 dimensions of PSQI scale was positively correlated with NCT and NLR (r = 0.370, 0.340, P = .020, .034).In our study, confirmed patients were prone to have psychological and sleep problems. The level of inflammation in patients with psychological and sleep problems was higher than that in patients without corresponding problems. The inflammatory level increased with the increase of Self-Rating Depression Scale score, and the lymphocyte count decreased with the increase of the PSQI score. NCT was prolonged in the anxiety group and sleep disturbance was positively correlated with NCT.
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Affiliation(s)
- Xixi Li
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Quan Cai
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Ziyi Jia
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yifang Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Linzi Liu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yuning Zhou
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Baoyan Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Luyu Ren
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yanqing Tang
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
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18
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Reif T, Dyckhoff G, Hohenberger R, Kolbe CC, Gruell H, Klein F, Latz E, Stolp B, Fackler OT. Contact-dependent inhibition of HIV-1 replication in ex vivo human tonsil cultures by polymorphonuclear neutrophils. CELL REPORTS MEDICINE 2021; 2:100317. [PMID: 34195682 PMCID: PMC8233696 DOI: 10.1016/j.xcrm.2021.100317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/02/2021] [Accepted: 05/20/2021] [Indexed: 12/01/2022]
Abstract
Polymorphonuclear neutrophils (PMNs), the most abundant white blood cells, are recruited rapidly to sites of infection to exert potent anti-microbial activity. Information regarding their role in infection with human immunodeficiency virus (HIV) is limited. Here we report that addition of PMNs to HIV-infected cultures of human tonsil tissue or peripheral blood mononuclear cells causes immediate and long-lasting suppression of HIV-1 spread and virus-induced depletion of CD4 T cells. This inhibition of HIV-1 spread strictly requires PMN contact with infected cells and is not mediated by soluble factors. 2-Photon (2PM) imaging visualized contacts of PMNs with HIV-1-infected CD4 T cells in tonsil tissue that do not result in lysis or uptake of infected cells. The anti-HIV activity of PMNs also does not involve degranulation, formation of neutrophil extracellular traps, or integrin-dependent cell communication. These results reveal that PMNs efficiently blunt HIV-1 replication in primary target cells and tissue by an unconventional mechanism. PMNs blunt HIV-1 spread and CD4 T cell depletion in HIV-infected human tonsils Suppression of HIV-1 replication by PMNs requires cell-cell contacts PMNs do not affect HIV via effector functions such as NETosis or degranulation PMNs exert unconventional antiviral activity
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Affiliation(s)
- Tatjana Reif
- Department of Infectious Diseases, Integrative Virology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Gerhard Dyckhoff
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Ralph Hohenberger
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Carl-Christian Kolbe
- Institute of Innate Immunity, Department of Innate Immunity and Metaflammation, University Hospital Bonn, 53127 Bonn, Germany
| | - Henning Gruell
- Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany.,German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, 50931 Cologne, Germany
| | - Florian Klein
- Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany.,German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, 50931 Cologne, Germany
| | - Eicke Latz
- Institute of Innate Immunity, Department of Innate Immunity and Metaflammation, University Hospital Bonn, 53127 Bonn, Germany
| | - Bettina Stolp
- Department of Infectious Diseases, Integrative Virology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Oliver T Fackler
- Department of Infectious Diseases, Integrative Virology, University Hospital Heidelberg, 69120 Heidelberg, Germany.,German Center for Infection Research (DZIF), Partner Site Heidelberg, 69120 Heidelberg, Germany
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19
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Ramesh J, Reddy SLS, Rajesh M, Varghese J. Evaluation of simple and cost-effective immuno- haematological markers to predict outcome in hospitalized severe COVID-19 patients, with a focus on diabetes mellitus - A retrospective study in Andhra Pradesh, India. Diabetes Metab Syndr 2021; 15:739-745. [PMID: 33819728 PMCID: PMC8006494 DOI: 10.1016/j.dsx.2021.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS COVID-19 pandemic has strained the health infrastructure globally, providing an opportunity to identify cost-effective biomarkers. We aimed to identify simple hematological prognostic markers in hospitalized severe COVID-19 patients with and without diabetes. METHODS Retrospective study of RT-PCR confirmed hospitalized severe COVID-19 patients (total: n = 154 patients, including diabetic subset n = 57) were analyzed. Clinically applicable cut-offs were derived using receiver operating characteristic (ROC) curve analysis for total leucocyte count (TLC), absolute neutrophil count (ANC), neutrophil lymphocyte ratio (NLR), and derived neutrophil lymphocyte ratio (dNLR) in order to prognosticate the outcome. RESULTS Among 154 severe COVID-19 patients, significant association with mortality was seen with respect to TLC(p < 0.001), ANC (p < 0.001), NLR(p < 0.001) and dNLR(p < 0.001). In the total cohort, applicable cut-offs based on ROC curve in predicting outcome were, for TLC 8950 cells/mm3 (area under curve (AUC)-0.764, odds ratio (OR)-7.53), ANC 7679 cells/mm3 (AUC-0.789, OR-8.14), NLR 5.13 (AUC-0.741, OR-4.77), dNLR 3.44 (AUC -0.741, OR-4.43) respectively.In diabetic subset, the cut-offs for TLC was 8950 cells/mm3 (AUC -0.762, OR-14.9), ANC 6510 cells/mm3 (AUC -0.773, OR-16.8), NLR 5.13(AUC -0.678, OR-6) and dNLR 3.25(AUC -0.685, OR-4.7) respectively. CONCLUSIONS In severe COVID-19 patients irrespective of diabetes, a simple, applicable total leucocyte count cut-off, 8950 cells/mm3 , together with easily derived cut-offs for ANC, NLR, dNLR may serve as cost-effective prognosticators of clinical outcome. A normal TLC may be misleading in the intensive care and the above applicable cut-off for TLC serves as an early warning tool for high-risk identification and better in-hospital management. Even with similar or lower cut-offs, diabetics had a higher mortality.
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Affiliation(s)
- Jayanthy Ramesh
- Department of Endocrinology, King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.
| | - S L Sagar Reddy
- Department of Endocrinology, King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.
| | - Moganti Rajesh
- Department of Endocrinology, King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.
| | - Johann Varghese
- Department of Endocrinology, King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.
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20
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COVID-IRS: A novel predictive score for risk of invasive mechanical ventilation in patients with COVID-19. PLoS One 2021; 16:e0248357. [PMID: 33819261 PMCID: PMC8021150 DOI: 10.1371/journal.pone.0248357] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/24/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a systemic disease that can rapidly progress into acute respiratory failure and death. Timely identification of these patients is crucial for a proper administration of health-care resources. OBJECTIVE To develop a predictive score that estimates the risk of invasive mechanical ventilation (IMV) among patients with COVID-19. STUDY DESIGN Retrospective cohort study of 401 COVID-19 patients diagnosed from March 12, to August 10, 2020. The score development cohort comprised 211 patients (52.62% of total sample) whereas the validation cohort included 190 patients (47.38% of total sample). We divided participants according to the need of invasive mechanical ventilation (IMV) and looked for potential predictive variables. RESULTS We developed two predictive scores, one based on Interleukin-6 (IL-6) and the other one on the Neutrophil/Lymphocyte ratio (NLR), using the following variables: respiratory rate, SpO2/FiO2 ratio and lactic dehydrogenase (LDH). The area under the curve (AUC) in the development cohort was 0.877 (0.823-0.931) using the NLR based score and 0.891 (0.843-0.939) using the IL-6 based score. When compared with other similar scores developed for the prediction of adverse outcomes in COVID-19, the COVID-IRS scores proved to be superior in the prediction of IMV. CONCLUSION The COVID-IRS scores accurately predict the need for mechanical ventilation in COVID-19 patients using readily available variables taken upon admission. More studies testing the applicability of COVID-IRS in other centers and populations, as well as its performance as a triage tool for COVID-19 patients are needed.
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21
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Penttilä PA, Van Gassen S, Panovska D, Vanderbeke L, Van Herck Y, Quintelier K, Emmaneel A, Filtjens J, Malengier-Devlies B, Ahmadzadeh K, Van Mol P, Borràs DM, Antoranz A, Bosisio FM, Wauters E, Martinod K, Matthys P, Saeys Y, Garg AD, Wauters J, De Smet F. High dimensional profiling identifies specific immune types along the recovery trajectories of critically ill COVID19 patients. Cell Mol Life Sci 2021; 78:3987-4002. [PMID: 33715015 PMCID: PMC7955698 DOI: 10.1007/s00018-021-03808-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/27/2021] [Accepted: 03/03/2021] [Indexed: 12/26/2022]
Abstract
The COVID-19 pandemic poses a major burden on healthcare and economic systems across the globe. Even though a majority of the population develops only minor symptoms upon SARS-CoV-2 infection, a significant number are hospitalized at intensive care units (ICU) requiring critical care. While insights into the early stages of the disease are rapidly expanding, the dynamic immunological processes occurring in critically ill patients throughout their recovery at ICU are far less understood. Here, we have analysed whole blood samples serially collected from 40 surviving COVID-19 patients throughout their recovery in ICU using high-dimensional cytometry by time-of-flight (CyTOF) and cytokine multiplexing. Based on the neutrophil-to-lymphocyte ratio (NLR), we defined four sequential immunotypes during recovery that correlated to various clinical parameters, including the level of respiratory support at concomitant sampling times. We identified classical monocytes as the first immune cell type to recover by restoration of HLA-DR-positivity and the reduction of immunosuppressive CD163 + monocytes, followed by the recovery of CD8 + and CD4 + T cell and non-classical monocyte populations. The identified immunotypes also correlated to aberrant cytokine and acute-phase reactant levels. Finally, integrative analysis of cytokines and immune cell profiles showed a shift from an initially dysregulated immune response to a more coordinated immunogenic interplay, highlighting the importance of longitudinal sampling to understand the pathophysiology underlying recovery from severe COVID-19.
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Affiliation(s)
- P A Penttilä
- KU Leuven Flow and Mass Cytometry Facility, KU Leuven, Leuven, Belgium
| | - S Van Gassen
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium.,Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, Ghent, Belgium
| | - D Panovska
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - L Vanderbeke
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Y Van Herck
- Laboratory of Experimental Oncology, Department of Oncology,, KU Leuven, Leuven, Belgium
| | - K Quintelier
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium.,Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, Ghent, Belgium
| | - A Emmaneel
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium.,Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, Ghent, Belgium
| | - J Filtjens
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - B Malengier-Devlies
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - K Ahmadzadeh
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - P Van Mol
- Laboratory of Translational Genetics, Department of Human Genetics, VIB-KU Leuven, Leuven, Belgium
| | - D M Borràs
- Laboratory for Cell Stress and Immunity (CSI), Department of Cellular and Molecular Medicine (CMM), KU Leuven, Leuven, Belgium
| | - A Antoranz
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - F M Bosisio
- Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - E Wauters
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - K Martinod
- Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - P Matthys
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Y Saeys
- Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, Ghent, Belgium
| | - A D Garg
- Laboratory for Cell Stress and Immunity (CSI), Department of Cellular and Molecular Medicine (CMM), KU Leuven, Leuven, Belgium
| | - J Wauters
- Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - F De Smet
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
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22
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Erol Koç EM, Fındık RB, Akkaya H, Karadağ I, Tokalıoğlu EÖ, Tekin ÖM. Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort. J Perinat Med 2021; 49:141-147. [PMID: 33544531 DOI: 10.1515/jpm-2020-0403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/13/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies. METHODS The current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group). RESULTS There was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001). CONCLUSIONS The study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.
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Affiliation(s)
- Esin Merve Erol Koç
- Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Rahime Bedir Fındık
- Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Hatice Akkaya
- Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Işılay Karadağ
- Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
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23
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Kabak M, Çil B, Hocanlı I. Relationship between leukocyte, neutrophil, lymphocyte, platelet counts, and neutrophil to lymphocyte ratio and polymerase chain reaction positivity. Int Immunopharmacol 2021; 93:107390. [PMID: 33529907 PMCID: PMC7846459 DOI: 10.1016/j.intimp.2021.107390] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 01/12/2023]
Abstract
Background Exposure to viral or bacterial pathogens increases the number of neutrophils with a relative decrease in lymphocytes, leading to elevated neutrophil to lymphocyte ratio (NLR). This study aimed to investigate whether differences in NLR among real-time polymerase chain reaction (PCR)-positive and -negative patients presenting with a prediagnosis of COVID-19 pneumonia could be useful in the differential diagnosis. Methods The study included 174 patients admitted because of suspected COVID-19 infection between March and April 2020. Patients were divided into two groups: PCR-negative and PCR-positive. Hemogram, NLR, urea, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, ferritin, D-dimer, C-reactive protein, procalcitonin, troponin, and coagulation parameters were analyzed. Results On comparison of laboratory parameters between both groups at presentation, PCR-positive patients were significantly more likely to have leukopenia (p < 0.001), thrombocytopenia (p = 0.006), neutropenia (p < 0.001), lymphopenia (p = 0.001), and increased NLR (p = 0.003). Furthermore, PCR-positive patients showed significant elevations of ferritin (p = 0.012) and procalcitonin (p = 0.038) and significant lower potassium levels (p = 0.05). Conclusion COVID-19 pneumonia has become a major global health problem. Early diagnosis and treatment of these patients are crucial, as COVID-19 pneumonia shows a rapid progression in most cases. Thus, leukopenia, thrombocytopenia, elevated NLR, and elevated ferritin may be useful as supplementary diagnostic tests in these patients, which may allow early initiation of treatment and may contribute to preventing progression in patients with abnormal results.
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Affiliation(s)
- M Kabak
- Mardin State Hospital, Department of Chest Disease, Mardin, Turkey.
| | - B Çil
- Mardin State Hospital, Department of Chest Disease, Mardin, Turkey.
| | - I Hocanlı
- Harran University Medical Faculty, Department of Chest Disease, Sanliurfa, Turkey.
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24
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Zhu R, Chen C, Wang Q, Zhang X, Lu C, Sun Y. Routine blood parameters are helpful for early identification of influenza infection in children. BMC Infect Dis 2020; 20:864. [PMID: 33213395 PMCID: PMC7676412 DOI: 10.1186/s12879-020-05584-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/04/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Routine blood parameters, such as the lymphocyte (LYM) count, platelet (PLT) count, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), lymphocytes multiplied by platelets (LYM*PLT) and mean platelet volume-to-platelet ratio (MPV/PLT), are widely used to predict the prognosis of infectious diseases. We aimed to explore the value of these parameters in the early identification of influenza virus infection in children. METHODS We conducted a single-center, retrospective, observational study of fever with influenza-like symptoms in pediatric outpatients from different age groups and evaluated the predictive value of various routine blood parameters measured within 48 h of the onset of fever for influenza virus infection. RESULTS The LYM count, PLT count, LMR and LYM*PLT were lower, and the NLR and MPV/PLT were higher in children with an influenza infection (PCR-confirmed and symptomatic). The LYM count, LMR and LYM*PLT in the influenza infection group were lower in the 1- to 6-year-old subgroup, and the LMR and LYM*PLT in the influenza infection group were lower in the > 6-year-old subgroup. In the 1- to 6-year-old subgroup, the cutoff value of the LMR for predicting influenza A virus infection was 3.75, the sensitivity was 81.87%, the specificity was 84.31%, and the area under the curve (AUC) was 0.886; the cutoff value of the LMR for predicting influenza B virus infection was 3.71, the sensitivity was 73.58%, the specificity was 84.31%, and the AUC was 0.843. In the > 6-year-old subgroup, the cutoff value of the LMR for predicting influenza A virus infection was 3.05, the sensitivity was 89.27%, the specificity was 89.61%, and the AUC was 0.949; the cutoff value of the LMR for predicting influenza B virus infection was 2.88, the sensitivity was 83.19%, the specificity was 92.21%, and the AUC was 0.924. CONCLUSIONS Routine blood tests are simple, inexpensive and easy to perform, and they are useful for the early identification of influenza virus infection in children. The LMR had the strongest predictive value for influenza virus infection in children older than 1 year, particularly in children older than 6 years with influenza A virus infection.
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Affiliation(s)
- Ronghe Zhu
- Department of Pediatrics, the First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, 325000, Zhejiang, China
| | - Cuie Chen
- Department of Pediatrics, Yiwu Maternity and Children Hospital, No. C100 Xinke Road, Yiwu, Jinhua, 322000, Zhejiang, China
| | - Qiu Wang
- Department of Pediatrics, the First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, 325000, Zhejiang, China
| | - Xixi Zhang
- Department of Pediatrics, People's Hospital of Yuhuan, No. 18 Changle Road, Yucheng Street, Yuhuan, Taizhou, 317600, Zhejiang, China
| | - Chaosheng Lu
- Department of Pediatrics, the First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, 325000, Zhejiang, China
| | - Yuanyuan Sun
- Department of Pediatrics, the First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, 325000, Zhejiang, China.
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25
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Mardani R, Alamdary A, Mousavi Nasab SD, Gholami R, Ahmadi N, Gholami A. Association of vitamin D with the modulation of the disease severity in COVID-19. Virus Res 2020; 289:198148. [PMID: 32866536 PMCID: PMC7455115 DOI: 10.1016/j.virusres.2020.198148] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 01/15/2023]
Abstract
In late 2019, SARS-CoV-2 started to spread throughout the world causing the COVID-19 that has taken a considerable number of lives. Results obtained from several investigations have explained the virus origin, pathogenicity, and transmission. Similar to SARS coronavirus, the pulmonary angiotensin converting enzyme (ACE) 2 was introduced as the virus receptor for entering the cell. An increased body of epidemiological and clinical evidences has shown modulating effects of vitamin D in lung injuries through several mechanisms. Several clinical symptoms as well as molecular factors have shown to be related to the disease transmission and severity. In this study, vitamin D, ACE concentrations, and neutrophil to lymphocyte ratio (NLR) were measured in patients with confirmed COVID-19 in comparison with control group. Results demonstrated significant alterations in vitamin D and ACE levels as well as NLR in the patients' group. Contribution of those factors with the prognosis and severity of the disease has been shown.
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Affiliation(s)
- R Mardani
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - A Alamdary
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - S D Mousavi Nasab
- Rotavaccine Research Lab, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - R Gholami
- Shoushtar University of Medical Sciences, Shoushtar, Iran
| | - N Ahmadi
- Proteomics Research Center, Department of Medical Lab Technology, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Gholami
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran.
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26
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Usul E, Şan İ, Bekgöz B, Şahin A. Role of hematological parameters in COVID-19 patients in the emergency room. Biomark Med 2020; 14:1207-1215. [PMID: 32692248 PMCID: PMC7372996 DOI: 10.2217/bmm-2020-0317] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 07/06/2020] [Indexed: 01/08/2023] Open
Abstract
Aim: In this study, the roles of biomarkers from a peripheral blood sample in the diagnosis of COVID-19 patients who have visited the emergency room have been evaluated. Materials & methods: Peripheral blood parameters, systemic inflammatory index (SII), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio were compared in patients with and without confirmed COVID-19 infection. Results: Comparisons made according to real-time PCR test results revealed that while no statistically significant difference was observed between test groups (negative-positive) regarding lymphocyte and platelet lymphocyte ratio values (p > 0.05), a statistically significant difference (p < 0.05) was found between the test groups regarding platelet, hemoglobin, leukocyte, neutrophil, NLR and SII values. Conclusion: Leukocyte, neutrophil, platelet count, NLR and SII values can be used in the diagnosis of COVID-19.
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Affiliation(s)
- Eren Usul
- Sincan Dr Nafiz Körez State Hospital, Emergency Service, Ankara, Turkey
| | - İshak Şan
- Department of Emergency Medicine, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Burak Bekgöz
- Department of Emergency Medicine, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ali Şahin
- Etimesgut State Hospital, Emergency Service, Ankara, Turkey
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27
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Wang H, Zhang Y, Mo P, Liu J, Wang H, Wang F, Zhao Q. Neutrophil to CD4+ lymphocyte ratio as a potential biomarker in predicting virus negative conversion time in COVID-19. Int Immunopharmacol 2020; 85:106683. [PMID: 32531713 PMCID: PMC7275184 DOI: 10.1016/j.intimp.2020.106683] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. Our study aimed to evaluate the robustness of neutrophil to CD4+ lymphocyte ratio (NCD4LR) in predicting the negative conversion time (NCT) of SARS-CoV-2 in COVID-19 patients. METHODS Univariate and multivariate analysis were conducted to evaluate the independency of NCD4LR in predicting NCT. Receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) were used to assess the diagnostic accuracy. RESULTS Compared with low NCD4LR patients, patients with high NCD4LR had an older age; higher incidence of fever, fatigue, chest distress/breath shortness, severer disease assessment on admission; higher levels of inflammatory indicators; low levels of lymphocyte subsets, and a longer NCT. Multivariate analysis also identified NCD4LR as an independent risk factor for delayed NCT. ROC analysis showed that NCD4LR had a better performance than neutrophil to lymphocyte ratio in predicting the virus negative conversion within 2 weeks (AUC = 0.772), 3 weeks (AUC = 0.710), 4 weeks (AUC = 0.728), or 5 weeks (AUC = 0.815). CONCLUSION This study suggests that NCD4LR is a potential and useful biomarker for predicting the virus negative conversion time in COVID-19 patients. Furthermore, due to the NCDLR value is easily calculated, it can be widely used as a clinical biomarker for disease progression and clinical outcomes in COVID-19 patients.
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Affiliation(s)
- Haizhou Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Yongxi Zhang
- Department of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China
| | - Pingzheng Mo
- Department of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China
| | - Jing Liu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Hongling Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Fan Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
| | - Qiu Zhao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
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28
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Rowaiye AB, Onuh OA, Oli AN, Okpalefe OA, Oni S, Nwankwo EJ. The pandemic COVID-19: a tale of viremia, cellular oxidation and immune dysfunction. Pan Afr Med J 2020; 36:188. [PMID: 32952832 PMCID: PMC7467617 DOI: 10.11604/pamj.2020.36.188.23476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/27/2020] [Indexed: 02/06/2023] Open
Abstract
COVID-19, caused by SARS-CoV-2 is a tester of the immune system. While it spares the healthy, it brings severe morbidity and in a few cases, mortality to its victims. This article aims at critically reviewing the key virulence factors of COVID-19 which are the viremia, cellular oxidation and immune dysfunction. The averse economic effect of certain disease control measures such as national lock-downs and social distancing, though beneficial, makes them unsustainable. Worse still is the fact that wild animals and domestic pets are carriers of SARS-CoV-2 suggesting that the disease would take longer than expected to be eradicated globally. A better understanding of the pathological dynamics of COVID-19 would help the general populace to prepare for possible infection by the invisible enemy. While the world prospects for vaccines and therapeutic agents against the SARS-CoV-2, clinicians should also seek to modulate the immune system for optimum performance. Immunoprophylactic and immunomodulatory strategies are recommended for the different strata of stakeholders combating the pandemic with the hope that morbidities and mortalities associated with COVID-19 would be drastically reduced.
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Affiliation(s)
- Adekunle Babajide Rowaiye
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria.,Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharm Scs, Nnamdi Azikiwe University, Awka, Nigeria
| | - Olukemi Adejoke Onuh
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria
| | - Angus Nnamdi Oli
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharm Scs, Nnamdi Azikiwe University, Awka, Nigeria
| | | | - Solomon Oni
- Bioresources Development Centre, Isanlu, National Biotechnology Development Agency, Abuja, Nigeria
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29
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Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol 2020; 84:106504. [PMID: 32304994 PMCID: PMC7152924 DOI: 10.1016/j.intimp.2020.106504] [Citation(s) in RCA: 572] [Impact Index Per Article: 143.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/21/2022]
Abstract
AIM To accumulate evidence that indicated the key role played by virus-triggered inflammation in the 2019-novel coronavirus disease (COVID-19) which emerged in Wuhan City and rapidly spread throughout China. METHODS Age, neutrophil(NEU)-to-lymphocyte (LYM) ratio (NLR), lymphocyte-to-monocyte (MON) ratio, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) of 93 patients with laboratory confirmed COVID-19 were investigated and compared. The receiver operating characteristic curve was applied to determine the thresholds for five bio-markers, and their prognostic values were assessed via the Kaplan-Meier curve and multivariate COX regression models. RESULTS The median age was 46.4 years old, and 37cases were females. A total of 27.8% of patients had been to Wuhan, and 73.1% had contacted with people from Wuhan. Fever (83.8%) and cough (70.9%) were the two most common symptoms. Elevated NLR and age were significantly associated with illness severity. The binary logistic analysis identified elevated NLR (hazard risk [HR] 2.46, 95% confidence interval [CI] 1.98-4.57) and age (HR 2.52, 95% CI 1.65-4.83) as independent factors for poor clinical outcome of COVID-19. NLR exhibited the largest area under the curve at 0.841, with the highest specificity (63.6%) and sensitivity (88%). CONCLUSIONS Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes.
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Affiliation(s)
- Ai-Ping Yang
- Department of Clinical Laboratory, Zhejiang Xiaoshan Hospital, No. 728, Yucai Road, Hangzhou, Zhejiang Province, PR China
| | - Jian-Ping Liu
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, No. 17 YongwaiZheng Street, Nanchang 330006, Jiangxi, China.
| | - Wen-Qiang Tao
- Department of Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hui-Ming Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, No. 17 YongwaiZheng Street, Nanchang 330006, Jiangxi, China
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30
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Li J, Gong X, Wang Z, Chen R, Li T, Zeng D, Li M. Clinical features of familial clustering in patients infected with 2019 novel coronavirus in Wuhan, China. Virus Res 2020; 286:198043. [PMID: 32502551 PMCID: PMC7265838 DOI: 10.1016/j.virusres.2020.198043] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/21/2020] [Accepted: 06/01/2020] [Indexed: 12/14/2022]
Abstract
In the study, we compared clinical characteristics of COVID-19 cases between cluster-onset families (COFs) and solitary-onset families (SOFs). Patients with exposure to respiratory droplets and close contact, advanced age, and comorbidities were more likely to develop COVID-19 in COFs. Advanced age and elevated neutrophil/lymphocyte ratio (NLR) were risk factors for death in patients with SARS-CoV-2 infection in COFs.
An epidemic caused by SARS-Coronavirus-2 (SARS-CoV-2) infection has appeared in Wuhan City in December 2019. The disease has shown a "clustering epidemic" pattern, and family-clustered onset has been the main characteristic. We collected data about 130 cases from 35 cluster-onset families (COFs) and 41 cases from 16 solitary-onset families (SOFs). The incidence of 2019 coronavirus disease (COVID-19) in COFs was significantly higher than that of SOFs. Our study also showed that patients with exposure to high-risk factors (respiratory droplets and close contact), advanced age, and comorbidities were more likely to develop COVID-19 in the COFs. In addition, advanced age and elevated neutrophil/lymphocyte ratio (NLR) were risk factors for death in patients with SARS-CoV-2 infection in the COFs.
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Affiliation(s)
- Jinzhong Li
- Departments of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Xiaobing Gong
- Departments of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Zhigang Wang
- Departments of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Renzhou Chen
- Department of General Surgery, Hankou Hospital of Wuhan City, Wuhan 430312, Hubei Province, China
| | - Taoyuan Li
- Departments of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Dongyu Zeng
- Departments of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Minran Li
- Departments of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China.
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Shang W, Dong J, Ren Y, Tian M, Li W, Hu J, Li Y. The value of clinical parameters in predicting the severity of COVID-19. J Med Virol 2020; 92:2188-2192. [PMID: 32436996 PMCID: PMC7280691 DOI: 10.1002/jmv.26031] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/15/2022]
Abstract
To study the relationship between clinical indexes and the severity of coronavirus disease 2019 (COVID-19), and to explore its role in predicting the severity of COVID-19. Clinical data of 443 patients with COVID-19 admitted to our hospital were retrospectively analyzed, which were divided into nonsevere group (n = 304) and severe group (n = 139) according to their condition. Clinical indicators were compared between different groups. The differences in sex, age, the proportion of patients with combined heart disease, leukocyte, neutrophil-to-lymphocyte ratio (NLR), neutrophil, lymphocyte, platelet, D-dimer, C-reactive protein (CRP), procalcitonin, lactate dehydrogenase, and albumin on admission between the two groups were statistically significant (P < .05). Multivariate logistic regression analysis showed NLR and CRP were independent risk factors for severe COVID-19. Platelets were independent protective factors for severe COVID-19. The receiver operating characteristic (ROC) curve analysis demonstrated area under the curve of NLR, platelet, CRP, and combination was 0.737, 0.634, 0.734, and 0.774, respectively. NLR, CRP, and platelets can effectively assess the severity of COVID-19, among which NLR is the best predictor of severe COVID-19, and the combination of three clinical indicators can further predict severe COVID-19.
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Affiliation(s)
- Weifeng Shang
- Department of Nephrology, Wuhan Forth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junwu Dong
- Department of Nephrology, Wuhan Forth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yali Ren
- Department of Medical Affaires, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Tian
- Department of Nephrology, Wuhan Forth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Li
- Department of Nephrology, Wuhan Forth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwu Hu
- Department of Respiratory Medicine, Wuhan Forth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Li
- Department of Respiratory Medicine, Wuhan Forth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Han Q, Wen X, Wang L, Han X, Shen Y, Cao J, Peng Q, Xu J, Zhao L, He J, Yuan H. Role of hematological parameters in the diagnosis of influenza virus infection in patients with respiratory tract infection symptoms. J Clin Lab Anal 2020; 34:e23191. [PMID: 31901184 PMCID: PMC7246361 DOI: 10.1002/jcla.23191] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/08/2019] [Accepted: 12/11/2019] [Indexed: 02/03/2023] Open
Abstract
Background The differential diagnoses of patients hospitalized for respiratory infections due to influenza virus vs other pathogens are challenging. Our study investigated whether hematological parameters such as neutrophil (N), lymphocyte (L), platelet (PLT), and neutrophil‐to‐lymphocyte ratio (NLR) contributed in diagnosing influenza virus infections and in discriminating other respiratory infections. Methods We retrospectively analyzed the laboratory characteristics of 307 patients with respiratory infections caused by influenza/non‐influenza virus and bacteria. The diagnostic abilities of hematological indexes were evaluated in the patients compared with 100 healthy people. Results The hematological parameters in patients with influenza virus infection were dramatically altered compared with those in the controls. Additionally, among the systemic inflammatory markers, the sensitivity of NLR for influenza detection was higher than that of N and L. PLT was significantly lower in influenza virus‐positive infection than in influenza virus‐negative infection. Moreover, when patients with influenza virus infection were cured, PLT returned to a normal level. The red blood cell (RBC) and hemoglobin (Hb) levels of influenza virus infection were higher than those of bacterial infection. Compared with traditional N and L, NLR and platelet‐to‐neutrophil (PNR) showed greater significance between influenza virus and bacterial infection (P < .01). Conclusion Neutrophil‐to‐lymphocyte ratio with high sensitivity is a preferable diagnostic tool to screen influenza virus‐infected patients than N and L. PLT accounts in the differential diagnoses of respiratory infections due to influenza virus and other pathogens among patients. In addition, RBC, Hb, NLR, and PNR can significantly differentiate between influenza virus infections and bacterial infections.
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Affiliation(s)
- Qingzhen Han
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaomin Wen
- Department of Clinical Laboratory, Shiqian People's Hospital, Tongren, China
| | - Lin Wang
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiu Han
- Department of Clinical Laboratory, Suzhou Dushuhu Public Hospital, Suzhou, China
| | - Yimin Shen
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun Cao
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qunxin Peng
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Xu
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lina Zhao
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun He
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hong Yuan
- Department of Clinical Laboratory, Shiqian People's Hospital, Tongren, China
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