Along with PaO2/FiO2 ratio and lymphopenia, low HLA-DR monocytes are the only additional parameter that independently predicts the clinical course of undifferentiated SARS-CoV-2 patients in Emergency Departments

J Leukoc Biol. 2024 Feb 15:qiae022. doi: 10.1093/jleuko/qiae022. Online ahead of print.ABSTRACTSince 1/3 of patients deteriorate after their admission to the emergency department (ED), assessing the prognosis of COVID-19 patients is of great importance. But to date, only lymphopenia and PaO2/FiO2 (P/F) ratio have been reported as partly predictive of COVID-19 further deterioration and their association has not been evaluated. We asked whether other key biomarkers of SARS-CoV2 immunologic defects - increase in circulating immature granulocytes (IGs), loss of monocyte HLA-DR (mHLA-DR) expression and monocyte differentiation blockade - could also predict further COVID-19 deterioration. A series of 284 consecutive COVID-19 patients with, as sole inclusion criterion of being an adult, were prospectively enrolled at ED admission (D0) of two different hospitals: one for the exploratory (180 patients) and one for the confirmatory cohort (104 patients). Deterioration was assessed over the next seven days. Neither increased IG levels nor monocyte differentiation blockade predicted patient worsening. Among more than 30 clinical, biological and radiological parameters, the value of decreased PaO2/FiO2 (P/F) ratio and lymphopenia for prediction of further COVID-19 deterioration was strongly confirmed and the loss of mHLA-DR was the only additional independent marker. Combined together in a simple OxyLymphoMono score, the three variables perfectly predicted patients who did not worsen and ...
Source: Journal of Leukocyte Biology - Category: Hematology Authors: Source Type: research