TY - JOUR
T1 - Observational cohort study of IP-10’s potential as a biomarker to aid in inflammation regulation within a clinical decision support protocol for patients with severe COVID-19
AU - Lev, Shaul
AU - Gottesman, Tamar
AU - Levin, Gal Sahaf
AU - Lederfein, Doron
AU - Berkov, Evgeny
AU - Diker, Dror
AU - Zaidman, Aliza
AU - Nutman, Amir
AU - Ber, Tahel Ilan
AU - Angel, Alon
AU - Kellerman, Lior
AU - Barash, Eran
AU - Navon, Roy
AU - Boico, Olga
AU - Israeli, Yael
AU - Rosenberg, Michal
AU - Gelman, Amir
AU - Kalfon, Roy
AU - Simon, Einav
AU - Avni, Noa
AU - Hainrichson, Mary
AU - Zarchin, Oren
AU - Gottlieb, Tanya M.
AU - Oved, Kfir
AU - Eden, Eran
AU - Tadmor, Boaz
N1 - Publisher Copyright:
© 2021 Lev et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Background Treatment of severely ill COVID-19 patients requires simultaneous management of oxygenation and inflammation without compromising viral clearance. While multiple tools are available to aid oxygenation, data supporting immune biomarkers for monitoring the host-pathogen interaction across disease stages and for titrating immunomodulatory therapy is lacking. Methods In this single-center cohort study, we used an immunoassay platform that enables rapid and quantitative measurement of interferon γ-induced protein 10 (IP-10), a host protein involved in lung injury from virus-induced hyperinflammation. A dynamic clinical decision support protocol was followed to manage patients infected with severe acute respiratory syndrome coronavirus 2 and examine the potential utility of timely and serial measurements of IP-10 as tool in regulating inflammation. Results Overall, 502 IP-10 measurements were performed on 52 patients between 7 April and 10 May 2020, with 12 patients admitted to the intensive care unit. IP-10 levels correlated with COVID-19 severity scores and admission to the intensive care unit. Among patients in the intensive care unit, the number of days with IP-10 levels exceeding 1,000 pg/mL was associated with mortality. Administration of corticosteroid immunomodulatory therapy decreased IP-10 levels significantly. Only two patients presented with subsequent IP-10 flare-ups exceeding 1,000 pg/mL and died of COVID-19-related complications. Conclusions Serial and readily available IP-10 measurements potentially represent an actionable aid in managing inflammation in COVID-19 patients and therapeutic decision-making. Trial registration Clinicaltrials.gov, NCT04389645, retrospectively registered on May 15, 2020.
AB - Background Treatment of severely ill COVID-19 patients requires simultaneous management of oxygenation and inflammation without compromising viral clearance. While multiple tools are available to aid oxygenation, data supporting immune biomarkers for monitoring the host-pathogen interaction across disease stages and for titrating immunomodulatory therapy is lacking. Methods In this single-center cohort study, we used an immunoassay platform that enables rapid and quantitative measurement of interferon γ-induced protein 10 (IP-10), a host protein involved in lung injury from virus-induced hyperinflammation. A dynamic clinical decision support protocol was followed to manage patients infected with severe acute respiratory syndrome coronavirus 2 and examine the potential utility of timely and serial measurements of IP-10 as tool in regulating inflammation. Results Overall, 502 IP-10 measurements were performed on 52 patients between 7 April and 10 May 2020, with 12 patients admitted to the intensive care unit. IP-10 levels correlated with COVID-19 severity scores and admission to the intensive care unit. Among patients in the intensive care unit, the number of days with IP-10 levels exceeding 1,000 pg/mL was associated with mortality. Administration of corticosteroid immunomodulatory therapy decreased IP-10 levels significantly. Only two patients presented with subsequent IP-10 flare-ups exceeding 1,000 pg/mL and died of COVID-19-related complications. Conclusions Serial and readily available IP-10 measurements potentially represent an actionable aid in managing inflammation in COVID-19 patients and therapeutic decision-making. Trial registration Clinicaltrials.gov, NCT04389645, retrospectively registered on May 15, 2020.
UR - http://www.scopus.com/inward/record.url?scp=85099910889&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0245296
DO - 10.1371/journal.pone.0245296
M3 - Article
C2 - 33434221
AN - SCOPUS:85099910889
SN - 1932-6203
VL - 16
JO - PLoS ONE
JF - PLoS ONE
IS - 1 January
M1 - e0245296
ER -
