Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Universally Available Innate and Adaptive Immune Cell Counts in Acute Ischemic Stroke (AIS) in the Context of Shared Pathobiology with COVID-19; Scoping Review

Version 1 : Received: 11 February 2021 / Approved: 11 February 2021 / Online: 11 February 2021 (19:01:45 CET)

How to cite: Wijeratne, T.; Sales, C.; Menon, R.; Karimi, L.; Jakovljevic, M. Universally Available Innate and Adaptive Immune Cell Counts in Acute Ischemic Stroke (AIS) in the Context of Shared Pathobiology with COVID-19; Scoping Review. Preprints 2021, 2021020291 (doi: 10.20944/preprints202102.0291.v1). Wijeratne, T.; Sales, C.; Menon, R.; Karimi, L.; Jakovljevic, M. Universally Available Innate and Adaptive Immune Cell Counts in Acute Ischemic Stroke (AIS) in the Context of Shared Pathobiology with COVID-19; Scoping Review. Preprints 2021, 2021020291 (doi: 10.20944/preprints202102.0291.v1).

Abstract

Stroke is one of the leading cause of adult disability and the second leading cause of death worldwide. The immune system actively participates in the pathobiological process of AIS, during the index event and during the repair process despite the limited attention drawn to this aspect in the existing stroke guidelines globally. The similar clinical course and similar circulating innate and adaptive immune cell counts in AIS and COVID-19 has created a renewed interest in these easily available biomarkers innate and adaptive immunological changes in AIS with potential diagnostic, prognostic, and therapeutic implications. The current scoping review aimed to assess the significance of circulating neutrophil and lymphocyte counts and their ratio (NLR) in AIS and explore their association with post-stroke recovery trajectory. The Arksey and O'Malley methodological framework was employed to review the published papers on the neutrophil-lymphocyte ratio (NLR) and AIS in late November 2020. Only studies published in English from 2000-2020 were included in this scoping review. Fifty-three published papers were reviewed. This review's key finding is that a canonical inflammatory response occurs in AIS just as in the case of COVID-19 and neurological involvements well described in the recent literature. An excessive circulating innate immune cells (neutrophils) and reduced circulating adaptive immune cells (lymphocytes ) are associated with poorer outcomes during the acute interventions ( reperfusion therapies) as well as the recovery trajectory. Main representatives of innate and adaptive immunity follow a canonical course in AIS and COVID-19. Exaggerated circulating innate ( elevated neutrophils and elevated NLR) and reduced adaptive immune response (lymphopenia) correlate with the worse outcome in AIS and COVID-19. This scoping review's findings make the strongest case for a systems biology-based approach to the standard operating procedures in stroke care urgently.

Subject Areas

stroke; neutrophil lymphocyte ratio; Systemic Immune Inflmmatory Indea; sustainable stroke care

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