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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Viral Immunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1501872
This article is part of the Research Topic Exploring Antiviral Immune Responses and Therapeutic Strategies Against Human Coronaviruses View all 3 articles

Prognostic performance of early immune and endothelial activation markers in mild-to-moderate COVID-19 outpatients: a nested casecontrol study

Provisionally accepted
Andrea Alemany Ortiz Andrea Alemany Ortiz 1*Núria Balanza Núria Balanza 1Pere Millat-Martinez Pere Millat-Martinez 1Dan Ouchi Dan Ouchi 1*Marc Corbacho-Monné Marc Corbacho-Monné 2*Cristian Morales-Indiano Cristian Morales-Indiano 3Gema Fernández-Rivas Gema Fernández-Rivas 4Ignacio Blanco Ignacio Blanco 4Oriol Mitjà Oriol Mitjà 2*Ruth Aguilar Ruth Aguilar 1Carlota Dobano Carlota Dobano 1Quique Bassat Quique Bassat 1Gemma Moncunill Gemma Moncunill 1Bàrbara Baro Bàrbara Baro 1*
  • 1 Instituto Salud Global Barcelona (ISGlobal), Barcelona, Spain
  • 2 Fight Against Infections Foundation, Badalona, Spain
  • 3 Hospital Germans Trias i Pujol, Barcelona, Balearic Islands, Spain
  • 4 Hospital Germans Trias i Pujol, Badalona, Spain

The final, formatted version of the article will be published soon.

    Evidence on the association of biomarkers of host response to infection with COVID-19 clinical outcomes has focused mainly on hospitalized patients. We investigated the prognostic performance of 39 immune and endothelial activation markers measured early in the course of disease to predict the development of severe COVID-19 and hospitalization. We conducted a nested case-control study from a randomized clinical trial evaluating the efficacy of COVID-19 convalescent plasma in outpatients aged 50 years or older presenting with mild-to-moderate COVID-19. We selected participants who were hospitalized within 28 days (cases) and who were not (controls) to compare their biomarker levels in plasma samples collected at enrolment. A total of 42 cases and 42 controls were included in this study. The levels of CRP, IL6, IP10, ferritin, IFNα, IL8, IL1RA, MCP1, and RANTES, determined within 7 days of symptoms onset, showed good individual prognostic performance for COVID-19 associated hospitalization by day 28. The biomarkers CRP, IL6, IP10, IL8, IL1RA, and suPAR showed good individual prognostic performance for severe COVID-19. CRP, IL6 and IP10 had the most robust association with both hospitalization and severe COVID-19, with CRP having the highest discriminatory capacity with hospitalization, and IL6 for severe COVID-19. Our study shows good prognostic performance of CRP and IL6 for 28-day hospitalization in patients with mild-to-moderate COVID-19, in the absence of clinical criteria for admission upon enrolment. These findings confirm the value of these biomarkers at early stages of COVID-19 disease in the outpatient setting to support management decisions.

    Keywords: biomarkers, host response, COVID-19, SARS-CoV-2, Outpatients

    Received: 25 Sep 2024; Accepted: 06 Nov 2024.

    Copyright: © 2024 Alemany Ortiz, Balanza, Millat-Martinez, Ouchi, Corbacho-Monné, Morales-Indiano, Fernández-Rivas, Blanco, Mitjà, Aguilar, Dobano, Bassat, Moncunill and Baro. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Andrea Alemany Ortiz, Instituto Salud Global Barcelona (ISGlobal), Barcelona, Spain
    Dan Ouchi, Instituto Salud Global Barcelona (ISGlobal), Barcelona, Spain
    Marc Corbacho-Monné, Fight Against Infections Foundation, Badalona, 08916, Spain
    Oriol Mitjà, Fight Against Infections Foundation, Badalona, 08916, Spain
    Bàrbara Baro, Instituto Salud Global Barcelona (ISGlobal), Barcelona, Spain

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.