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Decoding Immuno-Competence: A Novel Analysis of Complete Blood Cell Count Data in COVID-19 Outcomes.

作者信息

Kempaiah Prakasha, Libertin Claudia R, Chitale Rohit A, Naeyma Islam, Pleqi Vasili, Sheele Johnathan M, Iandiorio Michelle J, Hoogesteijn Almira L, Caulfield Thomas R, Rivas Ariel L

机构信息

Department of Medicine, Division of Infectious Diseases, Mayo Clinic, Jacksonville, FL 32224, USA.

Department of Critical Care, Mayo Clinic, Jacksonville, FL 32224, USA.

出版信息

Biomedicines. 2024 Apr 15;12(4):871. doi: 10.3390/biomedicines12040871.


DOI:10.3390/biomedicines12040871
PMID:38672225
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11048687/
Abstract

BACKGROUND: While 'immuno-competence' is a well-known term, it lacks an operational definition. To address this omission, this study explored whether the temporal and structured data of the complete blood cell count (CBC) can rapidly estimate immuno-competence. To this end, one or more ratios that included data on all monocytes, lymphocytes and neutrophils were investigated. MATERIALS AND METHODS: Longitudinal CBC data collected from 101 COVID-19 patients (291 observations) were analyzed. Dynamics were estimated with several approaches, which included non-structured (the classic CBC format) and structured data. Structured data were assessed as complex ratios that capture multicellular interactions among leukocytes. In comparing survivors with non-survivors, the hypothesis that immuno-competence may exhibit feedback-like (oscillatory or cyclic) responses was tested. RESULTS: While non-structured data did not distinguish survivors from non-survivors, structured data revealed immunological and statistical differences between outcomes: while survivors exhibited oscillatory data patterns, non-survivors did not. In survivors, many variables (including IL-6, hemoglobin and several complex indicators) showed values above or below the levels observed on day 1 of the hospitalization period, displaying L-shaped data distributions (positive kurtosis). In contrast, non-survivors did not exhibit kurtosis. Three immunologically defined data subsets included only survivors. Because information was based on visual patterns generated in real time, this method can, potentially, provide information rapidly. DISCUSSION: The hypothesis that immuno-competence expresses feedback-like loops when immunological data are structured was not rejected. This function seemed to be impaired in immuno-suppressed individuals. While this method rapidly informs, it is only a guide that, to be confirmed, requires additional tests. Despite this limitation, the fact that three protective (survival-associated) immunological data subsets were observed since day 1 supports many clinical decisions, including the early and personalized prognosis and identification of targets that immunomodulatory therapies could pursue. Because it extracts more information from the same data, structured data may replace the century-old format of the CBC.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/d4a4c3d2ea02/biomedicines-12-00871-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/8ca192c7ce90/biomedicines-12-00871-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/fc291286fc62/biomedicines-12-00871-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/8fc1c69b99f5/biomedicines-12-00871-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/c51354bec2e8/biomedicines-12-00871-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/84eb4d137a54/biomedicines-12-00871-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/fe16147eb8a0/biomedicines-12-00871-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/078134c8f544/biomedicines-12-00871-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/f61317f8e750/biomedicines-12-00871-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/97500aee167d/biomedicines-12-00871-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/fb2335f5eac9/biomedicines-12-00871-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/f1042aa536c3/biomedicines-12-00871-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/d4a4c3d2ea02/biomedicines-12-00871-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/8ca192c7ce90/biomedicines-12-00871-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/fc291286fc62/biomedicines-12-00871-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/8fc1c69b99f5/biomedicines-12-00871-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/c51354bec2e8/biomedicines-12-00871-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/84eb4d137a54/biomedicines-12-00871-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/fe16147eb8a0/biomedicines-12-00871-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/078134c8f544/biomedicines-12-00871-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/f61317f8e750/biomedicines-12-00871-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/97500aee167d/biomedicines-12-00871-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/fb2335f5eac9/biomedicines-12-00871-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/f1042aa536c3/biomedicines-12-00871-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f972/11048687/d4a4c3d2ea02/biomedicines-12-00871-g012.jpg

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引用本文的文献

[1]
Dynamics of Innate Immunity in SARS-CoV-2 Infections: Exploring the Impact of Natural Killer Cells, Inflammatory Responses, Viral Evasion Strategies, and Severity.

Cells. 2025-5-22

[2]
Personalized, disease-stage specific, rapid identification of immunosuppression in sepsis.

Front Immunol. 2024

本文引用的文献

[1]
From numbers to medical knowledge: harnessing combinatorial data patterns to predict COVID-19 resource needs and distinguish patient subsets.

Front Med (Lausanne). 2023-11-8

[2]
Sources of bias in observational studies of covid-19 vaccine effectiveness.

J Eval Clin Pract. 2024-2

[3]
Exploring the impact of selection bias in observational studies of COVID-19: a simulation study.

Int J Epidemiol. 2023-2-8

[4]
Data structuring may prevent ambiguity and improve personalized medical prognosis.

Mol Aspects Med. 2023-6

[5]
Hematological abnormalities in immunosuppressed patients with COVID-19: Evidence from a single center. A cross sectional study.

Int Immunopharmacol. 2022-8

[6]
Adaptive Immune Responses and Immunity to SARS-CoV-2.

Front Immunol. 2022

[7]
Immunosuppression and SARS-CoV-2 breakthrough infections.

Lancet Rheumatol. 2022-6

[8]
Time-Dependent Changes of Laboratory Parameters as Independent Predictors of All-Cause Mortality in COVID-19 Patients.

Biology (Basel). 2022-4-11

[9]
Multi-Cellular Immunological Interactions Associated With COVID-19 Infections.

Front Immunol. 2022

[10]
Survival and risk of COVID-19 after SARS-COV-2 vaccination in a series of 2391 cancer patients.

Eur J Cancer. 2022-4

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