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Gene . Serum CCL17 level becomes a predictive marker to distinguish between mild/moderate and severe/critical disease in patients with COVID-19

tetano

Editor, Senior Moderator
Gene


. 2020 Sep 14;145145.
doi: 10.1016/j.gene.2020.145145. Online ahead of print.
Serum CCL17 level becomes a predictive marker to distinguish between mild/moderate and severe/critical disease in patients with COVID-19


Masaya Sugiyama[SUP] 1 [/SUP], Noriko Kinoshita[SUP] 2 [/SUP], Satoshi Ide[SUP] 2 [/SUP], Hidetoshi Nomoto[SUP] 2 [/SUP], Takato Nakamoto[SUP] 2 [/SUP], Sho Saito[SUP] 2 [/SUP], Masahiro Ishikane[SUP] 2 [/SUP], Satoshi Kutsuna[SUP] 2 [/SUP], Kayoko Hayakawa[SUP] 2 [/SUP], Masao Hashimoto[SUP] 3 [/SUP], Manabu Suzuki[SUP] 3 [/SUP], Shinyu Izumi[SUP] 3 [/SUP], Masayuki Hojo[SUP] 3 [/SUP], Kiyoto Tsuchiya[SUP] 4 [/SUP], Hiroyuki Gatanaga[SUP] 4 [/SUP], Jin Takasaki[SUP] 3 [/SUP], Masahide Usami[SUP] 5 [/SUP], Toshikazu Kano[SUP] 6 [/SUP], Hidekatsu Yanai[SUP] 7 [/SUP], Nao Nishida[SUP] 8 [/SUP], Tatsuya Kanto[SUP] 9 [/SUP], Haruhito Sugiyama[SUP] 3 [/SUP], Norio Ohmagari[SUP] 10 [/SUP], Masashi Mizokami[SUP] 8 [/SUP]



Affiliations

Abstract

COVID-19, a novel coronavirus-related illness, has spread worldwide. Patients with apparently mild/moderate symptoms can suddenly develop severe pneumonia. Therefore, almost all COVID-19 patients require hospitalization, which can reduce limited medical resources in addition to overwhelming medical facilities. To identify predictive markers for the development of severe pneumonia, a comprehensive analysis of serum chemokines and cytokines was conducted using serial serum samples from COVID-19 patients. The expression profiles were analyzed along the time axis. Serum samples of common diseases were enrolled from a BioBank to confirm the usefulness of predictive markers. Five factors, IFN-λ3, IL-6, IP-10, CXCL9, and CCL17, were identified as predicting the onset of severe/critical symptoms. The factors were classified into two categories. Category A included IFN-λ3, IL-6, IP-10, and CXCL9, and their values surged and decreased rapidly before the onset of severe pneumonia. Category B included CCL17, which provided complete separation between the mild/moderate and the severe/critical groups at an early phase of SARS-CoV-2 infection. The five markers provided a high predictive value (area under the receiver operating characteristic curve (AUROC): 0.9-1.0, p < 0.001). Low expression of CCL17 was specifically observed in pre-severe COVID-19 patients compared with other common diseases, and the predictive ability of CCL17 was confirmed in validation samples of COVID-19. The factors identified could be promising prognostic markers to distinguish between mild/moderate and severe/critical patients, enabling triage at an early phase of infection, thus avoiding overwhelming medical facilities.

Keywords: CCL17; COVID-19; CXCL9; IFN-λ3; IL-6; IP-10; Predictive marker.
 
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