Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study
BackgroundTwo years since the onset of the COVID-19 pandemic no predictive algorithm has been generally adopted for clinical management and in most algorithms the contribution of laboratory variables is limited. ObjectivesTo measure the predictive performance of currently used clinical laboratory te...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:2445/188703 |
| Acceso en línea: | https://hdl.handle.net/2445/188703 |
| Access Level: | acceso abierto |
| Palabra clave: | COVID-19 Marcadors bioquímics Citocines Biochemical markers Cytokines |
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Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study |
| title |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study |
| spellingShingle |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study Sánchez Montalvá, Adrián COVID-19 Marcadors bioquímics Citocines COVID-19 Biochemical markers Cytokines |
| title_short |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study |
| title_full |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study |
| title_fullStr |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study |
| title_full_unstemmed |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study |
| title_sort |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot Study |
| dc.creator.none.fl_str_mv |
Sánchez Montalvá, Adrián Álvarez Sierra, Daniel Martínez Gallo, Mónica Perurena-Prieto, Janire Arrese Muñoz, Iria Ruiz Rodríguez, Juan Carlos Espinosa Pereiro, Juan Bosch Nicolau, Pau Martínez Gómez, Xavier Antón, Andrés Martínez Valle, Ferran Riveiro-Barciela, Mar Blanco Grau, Albert Rodríguez-Frías, Francisco Castellano Escuder, Pol Poyatos Canton, Elisabet Bas Minguet, Jordi Martínez Cáceres, Eva Sánchez Pla, Alex Zurera Egea, Coral Teniente Serra, Aina Hernández González, Manuel Pujol Borrell, Ricardo The Hospital Vall D’hebron Group for the study of Covid-19 Immune Profile |
| author |
Sánchez Montalvá, Adrián |
| author_facet |
Sánchez Montalvá, Adrián Álvarez Sierra, Daniel Martínez Gallo, Mónica Perurena-Prieto, Janire Arrese Muñoz, Iria Ruiz Rodríguez, Juan Carlos Espinosa Pereiro, Juan Bosch Nicolau, Pau Martínez Gómez, Xavier Antón, Andrés Martínez Valle, Ferran Riveiro-Barciela, Mar Blanco Grau, Albert Rodríguez-Frías, Francisco Castellano Escuder, Pol Poyatos Canton, Elisabet Bas Minguet, Jordi Martínez Cáceres, Eva Sánchez Pla, Alex Zurera Egea, Coral Teniente Serra, Aina Hernández González, Manuel Pujol Borrell, Ricardo The Hospital Vall D’hebron Group for the study of Covid-19 Immune Profile |
| author_role |
author |
| author2 |
Álvarez Sierra, Daniel Martínez Gallo, Mónica Perurena-Prieto, Janire Arrese Muñoz, Iria Ruiz Rodríguez, Juan Carlos Espinosa Pereiro, Juan Bosch Nicolau, Pau Martínez Gómez, Xavier Antón, Andrés Martínez Valle, Ferran Riveiro-Barciela, Mar Blanco Grau, Albert Rodríguez-Frías, Francisco Castellano Escuder, Pol Poyatos Canton, Elisabet Bas Minguet, Jordi Martínez Cáceres, Eva Sánchez Pla, Alex Zurera Egea, Coral Teniente Serra, Aina Hernández González, Manuel Pujol Borrell, Ricardo The Hospital Vall D’hebron Group for the study of Covid-19 Immune Profile |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
COVID-19 Marcadors bioquímics Citocines COVID-19 Biochemical markers Cytokines |
| topic |
COVID-19 Marcadors bioquímics Citocines COVID-19 Biochemical markers Cytokines |
| description |
BackgroundTwo years since the onset of the COVID-19 pandemic no predictive algorithm has been generally adopted for clinical management and in most algorithms the contribution of laboratory variables is limited. ObjectivesTo measure the predictive performance of currently used clinical laboratory tests alone or combined with clinical variables and explore the predictive power of immunological tests adequate for clinical laboratories. Methods: Data from 2,600 COVID-19 patients of the first wave of the pandemic in the Barcelona area (exploratory cohort of 1,579, validation cohorts of 598 and 423 patients) including clinical parameters and laboratory tests were retrospectively collected. 28-day survival and maximal severity were the main outcomes considered in the multiparametric classical and machine learning statistical analysis. A pilot study was conducted in two subgroups (n=74 and n=41) measuring 17 cytokines and 27 lymphocyte phenotypes respectively. Findings1) Despite a strong association of clinical and laboratory variables with the outcomes in classical pairwise analysis, the contribution of laboratory tests to the combined prediction power was limited by redundancy. Laboratory variables reflected only two types of processes: inflammation and organ damage but none reflected the immune response, one major determinant of prognosis. 2) Eight of the thirty variables: age, comorbidity index, oxygen saturation to fraction of inspired oxygen ratio, neutrophil-lymphocyte ratio, C-reactive protein, aspartate aminotransferase/alanine aminotransferase ratio, fibrinogen, and glomerular filtration rate captured most of the combined statistical predictive power. 3) The interpretation of clinical and laboratory variables was moderately improved by grouping them in two categories i.e., inflammation related biomarkers and organ damage related biomarkers; Age and organ damage-related biomarker tests were the best predictors of survival, and inflammatory-related ones were the best predictors of severity. 4) The pilot study identified immunological tests (CXCL10, IL-6, IL-1RA and CCL2), that performed better than most currently used laboratory tests. ConclusionsLaboratory tests for clinical management of COVID 19 patients are valuable but limited predictors due to redundancy; this limitation could be overcome by adding immunological tests with independent predictive power. Understanding the limitations of tests in use would improve their interpretation and simplify clinical management but a systematic search for better immunological biomarkers is urgent and feasible. |
| publishDate |
2022 |
| dc.date.none.fl_str_mv |
2022 2022 2022 2022 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/2445/188703 |
| url |
https://hdl.handle.net/2445/188703 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Reproducció del document publicat a: https://doi.org/10.3389/fimmu.2022.902837 Frontiers in Immunology, 2022, vol. 13, num. 902837 https://doi.org/10.3389/fimmu.2022.902837 |
| dc.rights.none.fl_str_mv |
cc by (c) Sánchez Montalvá, Adrián et al., 2022 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess |
| rights_invalid_str_mv |
cc by (c) Sánchez Montalvá, Adrián et al., 2022 http://creativecommons.org/licenses/by/3.0/es/ |
| eu_rights_str_mv |
openAccess |
| dc.format.none.fl_str_mv |
19 p. application/pdf |
| dc.publisher.none.fl_str_mv |
Frontiers Media SA |
| publisher.none.fl_str_mv |
Frontiers Media SA |
| dc.source.none.fl_str_mv |
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) reponame:Recercat. Dipósit de la Recerca de Catalunya instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| instname_str |
Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| reponame_str |
Recercat. Dipósit de la Recerca de Catalunya |
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Recercat. Dipósit de la Recerca de Catalunya |
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|
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1869424700745056256 |
| spelling |
Exposing and Overcoming Limitations of Clinical Laboratory Tests in COVID-19 by Adding Immunological Parameters; A Retrospective Cohort Analysis and Pilot StudySánchez Montalvá, AdriánÁlvarez Sierra, DanielMartínez Gallo, MónicaPerurena-Prieto, JanireArrese Muñoz, IriaRuiz Rodríguez, Juan CarlosEspinosa Pereiro, JuanBosch Nicolau, PauMartínez Gómez, XavierAntón, AndrésMartínez Valle, FerranRiveiro-Barciela, MarBlanco Grau, AlbertRodríguez-Frías, FranciscoCastellano Escuder, PolPoyatos Canton, ElisabetBas Minguet, JordiMartínez Cáceres, EvaSánchez Pla, AlexZurera Egea, CoralTeniente Serra, AinaHernández González, ManuelPujol Borrell, RicardoThe Hospital Vall D’hebron Group for the study of Covid-19 Immune ProfileCOVID-19Marcadors bioquímicsCitocinesCOVID-19Biochemical markersCytokinesBackgroundTwo years since the onset of the COVID-19 pandemic no predictive algorithm has been generally adopted for clinical management and in most algorithms the contribution of laboratory variables is limited. ObjectivesTo measure the predictive performance of currently used clinical laboratory tests alone or combined with clinical variables and explore the predictive power of immunological tests adequate for clinical laboratories. Methods: Data from 2,600 COVID-19 patients of the first wave of the pandemic in the Barcelona area (exploratory cohort of 1,579, validation cohorts of 598 and 423 patients) including clinical parameters and laboratory tests were retrospectively collected. 28-day survival and maximal severity were the main outcomes considered in the multiparametric classical and machine learning statistical analysis. A pilot study was conducted in two subgroups (n=74 and n=41) measuring 17 cytokines and 27 lymphocyte phenotypes respectively. Findings1) Despite a strong association of clinical and laboratory variables with the outcomes in classical pairwise analysis, the contribution of laboratory tests to the combined prediction power was limited by redundancy. Laboratory variables reflected only two types of processes: inflammation and organ damage but none reflected the immune response, one major determinant of prognosis. 2) Eight of the thirty variables: age, comorbidity index, oxygen saturation to fraction of inspired oxygen ratio, neutrophil-lymphocyte ratio, C-reactive protein, aspartate aminotransferase/alanine aminotransferase ratio, fibrinogen, and glomerular filtration rate captured most of the combined statistical predictive power. 3) The interpretation of clinical and laboratory variables was moderately improved by grouping them in two categories i.e., inflammation related biomarkers and organ damage related biomarkers; Age and organ damage-related biomarker tests were the best predictors of survival, and inflammatory-related ones were the best predictors of severity. 4) The pilot study identified immunological tests (CXCL10, IL-6, IL-1RA and CCL2), that performed better than most currently used laboratory tests. ConclusionsLaboratory tests for clinical management of COVID 19 patients are valuable but limited predictors due to redundancy; this limitation could be overcome by adding immunological tests with independent predictive power. Understanding the limitations of tests in use would improve their interpretation and simplify clinical management but a systematic search for better immunological biomarkers is urgent and feasible.Frontiers Media SA2022202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion19 p.application/pdfhttps://hdl.handle.net/2445/188703Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3389/fimmu.2022.902837Frontiers in Immunology, 2022, vol. 13, num. 902837https://doi.org/10.3389/fimmu.2022.902837cc by (c) Sánchez Montalvá, Adrián et al., 2022http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1887032026-05-29T05:05:01Z |
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15.812429 |