Circulating activated neutrophils in COVID-19: An independent predictor for mechanical ventilation and death

•Neutrophil activation predicts critical illness in COVID-19.•Aberrant neutrophil response in COVID-19.•Activated neutrophils are a novel biomarker for COVID-19.•Rapid detection of activated neutrophils by Sysmex™ hematology analyzer.•New avenue for therapeutic strategies in COVID-19. Critical illne...

Full description

Saved in:

Bibliographic Details
Published in:	International journal of infectious diseases Vol. 106; pp. 155 - 159
Main Authors:	Dennison, David, Al Khabori, Murtadha, Al Mamari, Sahimah, Aurelio, Allan, Al Hinai, Houda, Al Maamari, Khuloud, Alshekaili, Jalila, Al Khadouri, Ghalib
Format:	Journal Article
Language:	English
Published:	Canada Elsevier Ltd 01-05-2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases Elsevier
Subjects:	Aberrant neutrophil response Activated neutrophils Biomarker COVID-19 Critical illness Innate immunity COVID-19 Critical illness Innate immunity Biomarker Aberrant neutrophil response Activated neutrophils
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	•Neutrophil activation predicts critical illness in COVID-19.•Aberrant neutrophil response in COVID-19.•Activated neutrophils are a novel biomarker for COVID-19.•Rapid detection of activated neutrophils by Sysmex™ hematology analyzer.•New avenue for therapeutic strategies in COVID-19. Critical illness in COVID-19 is attributed to an exaggerated host immune response. Since neutrophils are the major component of innate immunity, we hypothesize that the quantum of activated neutrophils in the blood may predict an adverse outcome. In a retrospective study of 300 adult patients with confirmed COVID-19, we analyzed the impact of neutrophil activation (NEUT-RI), interleukin-6 (IL-6) and the established clinical risk factors of age, diabetes, obesity and hypertension on the clinical outcome. Significant predictors of the need for mechanical ventilation were NEUT-RI (Odds Ratio (OR) = 1.22, P < 0.001), diabetes (OR = 2.56, P = 0.00846) and obesity (OR = 6.55, P < 0.001). For death, the significant predictors were NEUT-RI (OR = 1.14, P = 0.00432), diabetes (OR = 4.11, P = 0.00185) and age (OR = 1.04, P = 0.00896). The optimal cut-off value for NEUT-RI to predict mechanical ventilation and death was 52 fluorescence intensity units (sensitivity 44%, specificity 88%, area under the curve 0.67 and 44%, 86%, 0.64, respectively). This finding supports an aberrant neutrophil response in COVID-19, likely due to uncontained viral replication, tissue hypoxia and exacerbated inflammation, introduces a novel biomarker for rapid monitoring and opens new avenues for therapeutic strategies.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1201-9712 1878-3511
DOI:	10.1016/j.ijid.2021.03.066