Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study

The COVID-19 pandemic has left an indelible mark globally, presenting numerous challenges to public health. This crisis, while disruptive and impactful, has provided a unique opportunity to gather precious clinical data extensively. In this observational, case-control study, we utilized data collect...

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Main Authors: Riccardo Giuseppe Margiotta, Emanuela Sozio, Fabio Del Ben, Antonio Paolo Beltrami, Daniela Cesselli, Marco Comar, Alessandra Devito, Martina Fabris, Francesco Curcio, Carlo Tascini, Guido Sanguinetti
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Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2024.1452638/full
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author Riccardo Giuseppe Margiotta
Emanuela Sozio
Fabio Del Ben
Fabio Del Ben
Antonio Paolo Beltrami
Antonio Paolo Beltrami
Daniela Cesselli
Daniela Cesselli
Marco Comar
Alessandra Devito
Martina Fabris
Martina Fabris
Francesco Curcio
Francesco Curcio
Carlo Tascini
Carlo Tascini
Guido Sanguinetti
author_facet Riccardo Giuseppe Margiotta
Emanuela Sozio
Fabio Del Ben
Fabio Del Ben
Antonio Paolo Beltrami
Antonio Paolo Beltrami
Daniela Cesselli
Daniela Cesselli
Marco Comar
Alessandra Devito
Martina Fabris
Martina Fabris
Francesco Curcio
Francesco Curcio
Carlo Tascini
Carlo Tascini
Guido Sanguinetti
author_sort Riccardo Giuseppe Margiotta
collection DOAJ
description The COVID-19 pandemic has left an indelible mark globally, presenting numerous challenges to public health. This crisis, while disruptive and impactful, has provided a unique opportunity to gather precious clinical data extensively. In this observational, case-control study, we utilized data collected at the Azienda Sanitaria Universitaria Friuli Centrale, Italy, to comprehensively characterize the immuno-inflammatory features in COVID-19 patients. Specifically, we employed multicolor flow cytometry, cytokine assays, and inflammatory biomarkers to elucidate the interplay between the infectious agent and the host’s immune status. We characterized immuno-inflammatory profiles within the first 72 hours of hospital admission, stratified by age, disease severity, and time elapsed since symptom onset. Our findings indicate that patients admitted to the hospital shortly after symptom onset exhibit a distinct pattern compared to those who arrive later, characterized by a more active immune response and heightened cytokine activity, but lower markers of tissue damage. We used univariate and multivariate logistic regression models to identify informative markers for outcome severity. Predictors incorporating the immuno-inflammatory features significantly outperformed standard baselines, identifying up to 59% of patients with positive outcomes while maintaining a false omission rate as low as 4%. Overall, our study sheds light on the immuno-inflammatory aspects observed in COVID-19 patients prior to vaccination, providing insights for guiding the clinical management of first-time infections by a novel virus.
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spelling doaj-art-929ed79fb2d446f6a54936815bc49ddf2025-01-08T06:11:42ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14526381452638Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective studyRiccardo Giuseppe Margiotta0Emanuela Sozio1Fabio Del Ben2Fabio Del Ben3Antonio Paolo Beltrami4Antonio Paolo Beltrami5Daniela Cesselli6Daniela Cesselli7Marco Comar8Alessandra Devito9Martina Fabris10Martina Fabris11Francesco Curcio12Francesco Curcio13Carlo Tascini14Carlo Tascini15Guido Sanguinetti16Physics Department, International School for Advanced Studies (SISSA), Trieste, ItalyInfectious Disease Unit, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Laboratory Medicine, ASU FC, Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Laboratory Medicine, ASU FC, Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Laboratory Medicine, ASU FC, Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Laboratory Medicine, ASU FC, Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Laboratory Medicine, ASU FC, Udine, ItalyInfectious Disease Unit, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, ItalyDepartment of Medicine (DMED), University of Udine, Udine, ItalyPhysics Department, International School for Advanced Studies (SISSA), Trieste, ItalyThe COVID-19 pandemic has left an indelible mark globally, presenting numerous challenges to public health. This crisis, while disruptive and impactful, has provided a unique opportunity to gather precious clinical data extensively. In this observational, case-control study, we utilized data collected at the Azienda Sanitaria Universitaria Friuli Centrale, Italy, to comprehensively characterize the immuno-inflammatory features in COVID-19 patients. Specifically, we employed multicolor flow cytometry, cytokine assays, and inflammatory biomarkers to elucidate the interplay between the infectious agent and the host’s immune status. We characterized immuno-inflammatory profiles within the first 72 hours of hospital admission, stratified by age, disease severity, and time elapsed since symptom onset. Our findings indicate that patients admitted to the hospital shortly after symptom onset exhibit a distinct pattern compared to those who arrive later, characterized by a more active immune response and heightened cytokine activity, but lower markers of tissue damage. We used univariate and multivariate logistic regression models to identify informative markers for outcome severity. Predictors incorporating the immuno-inflammatory features significantly outperformed standard baselines, identifying up to 59% of patients with positive outcomes while maintaining a false omission rate as low as 4%. Overall, our study sheds light on the immuno-inflammatory aspects observed in COVID-19 patients prior to vaccination, providing insights for guiding the clinical management of first-time infections by a novel virus.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1452638/fullCOVID-19cytokinesimmunologyinflammationflow cytometryimmune system
spellingShingle Riccardo Giuseppe Margiotta
Emanuela Sozio
Fabio Del Ben
Fabio Del Ben
Antonio Paolo Beltrami
Antonio Paolo Beltrami
Daniela Cesselli
Daniela Cesselli
Marco Comar
Alessandra Devito
Martina Fabris
Martina Fabris
Francesco Curcio
Francesco Curcio
Carlo Tascini
Carlo Tascini
Guido Sanguinetti
Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study
Frontiers in Immunology
COVID-19
cytokines
immunology
inflammation
flow cytometry
immune system
title Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study
title_full Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study
title_fullStr Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study
title_full_unstemmed Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study
title_short Investigating the relationship between the immune response and the severity of COVID-19: a large-cohort retrospective study
title_sort investigating the relationship between the immune response and the severity of covid 19 a large cohort retrospective study
topic COVID-19
cytokines
immunology
inflammation
flow cytometry
immune system
url https://www.frontiersin.org/articles/10.3389/fimmu.2024.1452638/full
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