Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients

Matteo Regolo
ORCID logo ,
Alessandra Sorce
ORCID logo ,
Mauro Vaccaro
,
Michele Colaci
ORCID logo ,
Benedetta Stancanelli
,
Giuseppe Natoli
,
Massimo Motta
,
Ivan Isaia
,
Federica Castelletti
,
Federica Giangreco
,
Daniela Fichera
,
Paola Aparo
,
Alessandra Lanzafame
,
Mario Russo
,
Nicola Santangelo
,
Paola Noto
,
Lorenzo Malatino
* ORCID logo
Version 1 : Received: 10 May 2023 / Approved: 11 May 2023 / Online: 11 May 2023 (07:07:51 CEST)

A peer-reviewed article of this Preprint also exists.

Regolo, M.; Sorce, A.; Vaccaro, M.; Colaci, M.; Stancanelli, B.; Natoli, G.; Motta, M.; Isaia, I.; Castelletti, F.; Giangreco, F.; Fichera, D.; Aparo, P.; Lanzafame, A.; Russo, M.; Santangelo, N.; Noto, P.; Malatino, L. Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients. J. Clin. Med. 2023, 12, 4057. Regolo, M.; Sorce, A.; Vaccaro, M.; Colaci, M.; Stancanelli, B.; Natoli, G.; Motta, M.; Isaia, I.; Castelletti, F.; Giangreco, F.; Fichera, D.; Aparo, P.; Lanzafame, A.; Russo, M.; Santangelo, N.; Noto, P.; Malatino, L. Assessing Humoral Immuno-Inflammatory Pathways Associated with Respiratory Failure in COVID-19 Patients. J. Clin. Med. 2023, 12, 4057.

Abstract

All severe cases of SARS-CoV-2 infections are characterized by a high risk of disease progression towards ARDS, leading to bad outcome. Respiratory symptoms in COVID-19 patients often do not correspond to disease’s worsening. A dysregulated host response to the large viral load could play a key role in the disease progression. In our sample median age was 74 years (72-75) and 54% were men. Median period of hospitalization was 9 days. Firstly, we observed an asynchronous trend of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in 764 selected among 963 patients who were consecutively recruited in two hospitals (Cannizzaro, S. Marco) in Catania, Italy. NLR values in deceased patients showed an increase from baseline over time. By contrast, CRP tended to fall from baseline to median day of hospitalization in all four subgroups, but steeply increased at the end of hospitalization only in ICU-admitted patients. Then we evaluated the relationships between NLR and CRP as continuous variables with PaO2/FiO2 ratio (P/F). Finally, we made mediation and moderation analyses to determine the link between inflammation (CRP), immune system (neutrophils and lymphocytes) and respiratory failure (P/F). CRP, neutrophils and P/F are linked in the same pathogenetic chain leading to respiratory failure.

Keywords

NLR; CRP; P/F; COVID-19; Neutrophil-to-lymphocyte ratio; Neutrophils; Lymphocytes; immune system; biomarkers; SARS-CoV-2; inflammation; ICU; lung failure

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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