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中性粒细胞与淋巴细胞比值及细胞因子谱作为未接种疫苗的COVID-19患者疾病严重程度和生存的预测指标

Neutrophil-to-Lymphocyte Ratio and Cytokine Profiling as Predictors of Disease Severity and Survival in Unvaccinated COVID-19 Patients.

作者信息

Méndez Rodríguez Miguel Leonardo, Ponciano-Gómez Alberto, Campos-Aguilar Myriam, Tapia-Sánchez Wilfrido David, Duarte-Martínez Carlos Leonardo, Romero-Herrera Jesús Salvador, Olivas-Quintero Sandra, Saucedo-Campos Alberto Daniel, Méndez-Cruz Adolfo Rene, Jimenez-Flores Rafael, Ortiz-Navarrete Vianney, Romero-Ramírez Hector, Santos-Argumedo Leopoldo, Rosales-García Victor Hugo

机构信息

Servicio de Inmunología y Alergia, Centro Médico Naval (CEMENAV), Secretaria de Marina (SEMAR), Avenida Heroica Escuela Naval Militar 745, Coapa, Presidentes Ejidales 1ra Sección, Coyoacán, Mexico City 04470, Mexico.

Laboratorio de Inmunología (UMF), Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Estado de México, Mexico.

出版信息

Vaccines (Basel). 2024 Jul 31;12(8):861. doi: 10.3390/vaccines12080861.

Abstract

BACKGROUND

During the COVID-19 pandemic, identifying reliable biomarkers for predicting disease severity and patient outcomes in unvaccinated individuals is essential. This study evaluates the efficacy of key hematological markers, including leukocyte and neutrophil counts, Neutrophil-to-Lymphocyte Ratio (NLR), and cytokine profiles (IL-6, INF-γ, TNF-α, IL-17A, CCL2, and CXCL10) for predicting the necessity for mechanical ventilation and assessing survival probabilities.

METHODS

We conducted an in-depth analysis on a cohort of COVID-19 patients, emphasizing the relationship between NLR, cytokine profiles, and clinical outcomes, utilizing routine leukocyte counting and cytokine quantification by flow cytometry.

RESULTS

Elevated leukocyte and neutrophil counts, increased NLR, and significant cytokine elevations such as IL-6 and IL-10 were strongly associated with the need for mechanical ventilation, reflecting a pronounced systemic inflammatory response indicative of severe disease outcomes.

CONCLUSION

Integrating hematological markers, particularly NLR and cytokine profiles, is crucial in predicting mechanical ventilation needs and survival in non-vaccinated COVID-19 patients. Our findings provide critical insights into the pathophysiology of COVID-19, supporting the development of more targeted clinical interventions and potentially informing future strategies for managing infectious disease outbreaks.

摘要

背景

在新冠疫情期间,识别可靠的生物标志物以预测未接种疫苗个体的疾病严重程度和患者预后至关重要。本研究评估关键血液学标志物的功效,包括白细胞和中性粒细胞计数、中性粒细胞与淋巴细胞比值(NLR)以及细胞因子谱(IL-6、INF-γ、TNF-α、IL-17A、CCL2和CXCL10),以预测机械通气的必要性并评估生存概率。

方法

我们对一组新冠患者进行了深入分析,通过流式细胞术进行常规白细胞计数和细胞因子定量,着重研究NLR、细胞因子谱与临床结局之间的关系。

结果

白细胞和中性粒细胞计数升高、NLR增加以及IL-6和IL-10等细胞因子显著升高与机械通气需求密切相关,反映出明显的全身炎症反应,表明疾病预后严重。

结论

整合血液学标志物,尤其是NLR和细胞因子谱,对于预测未接种疫苗的新冠患者的机械通气需求和生存情况至关重要。我们的研究结果为新冠的病理生理学提供了关键见解,支持开发更具针对性的临床干预措施,并可能为未来传染病爆发的管理策略提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8740/11360520/2b9f631eba81/vaccines-12-00861-g001.jpg

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