Journal Article

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

Santos, Mayara Fraga, Luiz, Ronir Raggio, Domiciano, Rafael A. M., Pimentel-Coelho, Pedro M., De Luca, Fábio A., Maia, Luciana C. R., Bozza, Fernando A., de Oliveira, Nathália M., Medei, Emiliano, Feldman, André, de Paula, Thiago Ceccatto, Macedo, Ariane V. S., Giusti, Karla G. D., Moll-Bernardes, Renata, Castro, Mauro J. C., de Albuquerque, Denílson C., Loures, Vitor A., de Sousa, Andrea Silvestre, Lopes, Renato D., Vera, Narendra, Arruda, Guilherme D. A. S., Furquim, Thyago A. B., Kotsugai, Marisol D. M., de Souza, Olga Ferreira

2021

Overview

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.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: biomarker / Biomarkers / Cardiovascular Medicine / COVID-19 / cytokine / Cytokines / Diabetes / Disease progression / Enzymes / Granulocytes / Growth factors / Hypertension / Immune response / inflammation / Metabolic disorders / Oxygen saturation / Patients / prognosis / Proteins / Severe acute respiratory syndrome coronavirus 2 / Tumor necrosis factor-TNF / Ventilators