AUTHOR=Moll-Bernardes Renata , de Sousa Andrea Silvestre , Macedo Ariane V. S. , Lopes Renato D. , Vera Narendra , Maia Luciana C. R. , Feldman André , Arruda Guilherme D. A. S. , Castro Mauro J. C. , Pimentel-Coelho Pedro M. , de Albuquerque Denílson C. , de Paula Thiago Ceccatto , Furquim Thyago A. B. , Loures Vitor A. , Giusti Karla G. D. , de Oliveira Nathália M. , De Luca Fábio A. , Kotsugai Marisol D. M. , Domiciano Rafael A. M. , Santos Mayara Fraga , de Souza Olga Ferreira , Bozza Fernando A. , Luiz Ronir Raggio , Medei Emiliano
TITLE=IL-10 and IL-12 (P70) Levels Predict the Risk of Covid-19 Progression in Hypertensive Patients: Insights From the BRACE-CORONA Trial
JOURNAL=Frontiers in Cardiovascular Medicine
VOLUME=8
YEAR=2021
URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.702507
DOI=10.3389/fcvm.2021.702507
ISSN=2297-055X
ABSTRACT=Background: Cardiovascular comorbidities such as hypertension and inflammatory response dysregulation are associated with worse COVID-19 prognoses. Different cytokines have been proposed to play vital pathophysiological roles in COVID-19 progression, but appropriate prognostic biomarkers remain lacking. We hypothesized that the combination of immunological and clinical variables at admission could predict the clinical progression of COVID-19 in hypertensive patients.
Methods: The levels of biomarkers, including C-reactive protein, lymphocytes, monocytes, and a panel of 29 cytokines, were measured in blood samples from 167 hypertensive patients included in the BRACE-CORONA trial. The primary outcome was the highest score during hospitalization on the modified WHO Ordinal Scale for Clinical Improvement. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and biomarkers associated significantly with the primary outcome.
Results: During hospitalization, 13 (7.8%) patients showed progression to more severe forms of COVID-19, including three deaths. Obesity, diabetes, oxygen saturation, lung involvement on computed tomography examination, the C-reactive protein level, levels of 15 cytokines, and lymphopenia on admission were associated with progression to severe COVID-19. Elevated levels of interleukin-10 and interleukin-12 (p70) combined with two or three of the abovementioned clinical comorbidities were associated strongly with progression to severe COVID-19. The risk of progression to severe disease reached 97.5% in the presence of the five variables included in our model.
Conclusions: This study demonstrated that interleukin-10 and interleukin-12 (p70) levels, in combination with clinical variables, at hospital admission are key biomarkers associated with an increased risk of disease progression in hypertensive patients with COVID-19.