IL-10 and IL-12 (P70) Levels Predict the Risk of Covid-19 Progression in Hypertensive Patients: Insights From the BRACE-CORONA Trial

Frontiers in Cardiovascular Medicine

Mauro J. C. Castro¹  Denílson C. de Albuquerque²  Thyago A. B. Furquim³  Karla G. D. Giusti⁴  Nathália M. de Oliveira⁴  Marisol D. M. Kotsugai⁵  Fábio A. De Luca⁵  Olga Ferreira de Souza⁶  Ronir Raggio Luiz⁷  Emiliano Medei⁸  Renato D. Lopes⁹  Renata Moll-Bernardes^1,10  Mayara Fraga Santos^1,10  Andrea Silvestre de Sousa^1,12  Fernando A. Bozza^1,12  Rafael A. M. Domiciano^1,13  André Feldman^1,13  Vitor A. Loures^1,13  Thiago Ceccatto de Paula^1,14  Guilherme D. A. S. Arruda^1,15  Narendra Vera^1,16  Luciana C. R. Maia^1,16  Pedro M. Pimentel-Coelho^1,16  Ariane V. S. Macedo^1,17 

[1] 0Instituto de Microbiologia Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;1Cardiology Department, Rio de Janeiro State University, Rio de Janeiro, Brazil;2Hospital Sino Brasileiro, Osasco, Brazil;3Hospital Villa Lobos, São Paulo, Brazil;4Hospital São Luiz Morumbi, São Paulo, Brazil;5Hospital Copa Star, Rio de Janeiro, Brazil;6Institute for Studies in Public Health—IESC, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;7National Center for Structural Biology and Bioimaging, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;Brazilian Clinical Research Institute, São Paulo, Brazil;D'Or Institute for Research and Education, Rio de Janeiro, Brazil;Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, United States;Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;Hospital São Luiz Anália Franco, São Paulo, Brazil;Hospital São Luiz Jabaquara, São Paulo, Brazil;Hospital São Luiz São Caetano, São Caetano do Sul, Brazil;Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;Santa Casa de São Paulo, São Paulo, Brazil;

关键词: hypertension;    cytokine;    COVID-19;    biomarker;    inflammation;    prognosis;   

DOI  :  10.3389/fcvm.2021.702507

来源: DOAJ

【 摘 要 】

Background: Cardiovascular comorbidities such as hypertension and inflammatory response dysregulation are associated with worse COVID-19 prognoses. Different cytokines have been proposed to play vital pathophysiological roles in COVID-19 progression, but appropriate prognostic biomarkers remain lacking. We hypothesized that the combination of immunological and clinical variables at admission could predict the clinical progression of COVID-19 in hypertensive patients.Methods: The levels of biomarkers, including C-reactive protein, lymphocytes, monocytes, and a panel of 29 cytokines, were measured in blood samples from 167 hypertensive patients included in the BRACE-CORONA trial. The primary outcome was the highest score during hospitalization on the modified WHO Ordinal Scale for Clinical Improvement. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and biomarkers associated significantly with the primary outcome.Results: During hospitalization, 13 (7.8%) patients showed progression to more severe forms of COVID-19, including three deaths. Obesity, diabetes, oxygen saturation, lung involvement on computed tomography examination, the C-reactive protein level, levels of 15 cytokines, and lymphopenia on admission were associated with progression to severe COVID-19. Elevated levels of interleukin-10 and interleukin-12 (p70) combined with two or three of the abovementioned clinical comorbidities were associated strongly with progression to severe COVID-19. The risk of progression to severe disease reached 97.5% in the presence of the five variables included in our model.Conclusions: This study demonstrated that interleukin-10 and interleukin-12 (p70) levels, in combination with clinical variables, at hospital admission are key biomarkers associated with an increased risk of disease progression in hypertensive patients with COVID-19.

【 授权许可】

Unknown