tetano
Editor, Senior Moderator
PLoS One
. 2021 Jan 12;16(1):e0245296.
doi: 10.1371/journal.pone.0245296. eCollection 2021.
Observational cohort study of IP-10's potential as a biomarker to aid in inflammation regulation within a clinical decision support protocol for patients with severe COVID-19
Shaul Lev[SUP] 1 2 [/SUP], Tamar Gottesman[SUP] 2 3 [/SUP], Gal Sahaf Levin[SUP] 1 2 [/SUP], Doron Lederfein[SUP] 4 [/SUP], Evgeny Berkov[SUP] 5 [/SUP], Dror Diker[SUP] 5 [/SUP], Aliza Zaidman[SUP] 5 [/SUP], Amir Nutman[SUP] 2 6 [/SUP], Tahel Ilan Ber[SUP] 7 [/SUP], Alon Angel[SUP] 7 [/SUP], Lior Kellerman[SUP] 7 [/SUP], Eran Barash[SUP] 7 [/SUP], Roy Navon[SUP] 7 [/SUP], Olga Boico[SUP] 7 [/SUP], Yael Israeli[SUP] 7 [/SUP], Michal Rosenberg[SUP] 7 [/SUP], Amir Gelman[SUP] 7 [/SUP], Roy Kalfon[SUP] 7 [/SUP], Einav Simon[SUP] 7 [/SUP], Noa Avni[SUP] 7 [/SUP], Mary Hainrichson[SUP] 7 [/SUP], Oren Zarchin[SUP] 7 [/SUP], Tanya M Gottlieb[SUP] 7 [/SUP], Kfir Oved[SUP] 7 [/SUP], Eran Eden[SUP] 7 [/SUP], Boaz Tadmor[SUP] 4 [/SUP]
Affiliations
Abstract
Background: Treatment of severely ill COVID-19 patients requires simultaneous management of oxygenation and inflammation without compromising viral clearance. While multiple tools are available to aid oxygenation, data supporting immune biomarkers for monitoring the host-pathogen interaction across disease stages and for titrating immunomodulatory therapy is lacking.
Methods: In this single-center cohort study, we used an immunoassay platform that enables rapid and quantitative measurement of interferon γ-induced protein 10 (IP-10), a host protein involved in lung injury from virus-induced hyperinflammation. A dynamic clinical decision support protocol was followed to manage patients infected with severe acute respiratory syndrome coronavirus 2 and examine the potential utility of timely and serial measurements of IP-10 as tool in regulating inflammation.
Results: Overall, 502 IP-10 measurements were performed on 52 patients between 7 April and 10 May 2020, with 12 patients admitted to the intensive care unit. IP-10 levels correlated with COVID-19 severity scores and admission to the intensive care unit. Among patients in the intensive care unit, the number of days with IP-10 levels exceeding 1,000 pg/mL was associated with mortality. Administration of corticosteroid immunomodulatory therapy decreased IP-10 levels significantly. Only two patients presented with subsequent IP-10 flare-ups exceeding 1,000 pg/mL and died of COVID-19-related complications.
Conclusions: Serial and readily available IP-10 measurements potentially represent an actionable aid in managing inflammation in COVID-19 patients and therapeutic decision-making.
Trial registration: Clinicaltrials.gov, NCT04389645, retrospectively registered on May 15, 2020.
. 2021 Jan 12;16(1):e0245296.
doi: 10.1371/journal.pone.0245296. eCollection 2021.
Observational cohort study of IP-10's potential as a biomarker to aid in inflammation regulation within a clinical decision support protocol for patients with severe COVID-19
Shaul Lev[SUP] 1 2 [/SUP], Tamar Gottesman[SUP] 2 3 [/SUP], Gal Sahaf Levin[SUP] 1 2 [/SUP], Doron Lederfein[SUP] 4 [/SUP], Evgeny Berkov[SUP] 5 [/SUP], Dror Diker[SUP] 5 [/SUP], Aliza Zaidman[SUP] 5 [/SUP], Amir Nutman[SUP] 2 6 [/SUP], Tahel Ilan Ber[SUP] 7 [/SUP], Alon Angel[SUP] 7 [/SUP], Lior Kellerman[SUP] 7 [/SUP], Eran Barash[SUP] 7 [/SUP], Roy Navon[SUP] 7 [/SUP], Olga Boico[SUP] 7 [/SUP], Yael Israeli[SUP] 7 [/SUP], Michal Rosenberg[SUP] 7 [/SUP], Amir Gelman[SUP] 7 [/SUP], Roy Kalfon[SUP] 7 [/SUP], Einav Simon[SUP] 7 [/SUP], Noa Avni[SUP] 7 [/SUP], Mary Hainrichson[SUP] 7 [/SUP], Oren Zarchin[SUP] 7 [/SUP], Tanya M Gottlieb[SUP] 7 [/SUP], Kfir Oved[SUP] 7 [/SUP], Eran Eden[SUP] 7 [/SUP], Boaz Tadmor[SUP] 4 [/SUP]
Affiliations
- PMID: 33434221
- DOI: 10.1371/journal.pone.0245296
Abstract
Background: Treatment of severely ill COVID-19 patients requires simultaneous management of oxygenation and inflammation without compromising viral clearance. While multiple tools are available to aid oxygenation, data supporting immune biomarkers for monitoring the host-pathogen interaction across disease stages and for titrating immunomodulatory therapy is lacking.
Methods: In this single-center cohort study, we used an immunoassay platform that enables rapid and quantitative measurement of interferon γ-induced protein 10 (IP-10), a host protein involved in lung injury from virus-induced hyperinflammation. A dynamic clinical decision support protocol was followed to manage patients infected with severe acute respiratory syndrome coronavirus 2 and examine the potential utility of timely and serial measurements of IP-10 as tool in regulating inflammation.
Results: Overall, 502 IP-10 measurements were performed on 52 patients between 7 April and 10 May 2020, with 12 patients admitted to the intensive care unit. IP-10 levels correlated with COVID-19 severity scores and admission to the intensive care unit. Among patients in the intensive care unit, the number of days with IP-10 levels exceeding 1,000 pg/mL was associated with mortality. Administration of corticosteroid immunomodulatory therapy decreased IP-10 levels significantly. Only two patients presented with subsequent IP-10 flare-ups exceeding 1,000 pg/mL and died of COVID-19-related complications.
Conclusions: Serial and readily available IP-10 measurements potentially represent an actionable aid in managing inflammation in COVID-19 patients and therapeutic decision-making.
Trial registration: Clinicaltrials.gov, NCT04389645, retrospectively registered on May 15, 2020.