Clinico-Biological Features and Clonal Hematopoiesis in Patients with Severe COVID-19
Clinico-Biological Features and Clonal Hematopoiesis in Patients with Severe COVID-19
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DOI：
10.3390/cancers12071992
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发表时间：
2020-07-01
期刊：
影响因子：
5.2
通讯作者：
Quesnel, Bruno
中科院分区：
文献类型：
--
作者：
Duployez, Nicolas;Demonchy, Jordane;Quesnel, Bruno
高龄或先前存在的合并症已被描述为需要住院和重症监护的严重2019冠状病毒病（COVID-19）病例的风险因素。近年来，克隆造血（CH）的不确定的潜力（CHIP）已成为一个危险因素的慢性炎症背景和随后的衰老相关疾病。本研究的目的是确定与临床恶化风险相关的生物学因素（特别是白细胞亚型和炎症标志物）（即，经口气管插管（OTI）），并确定CH是否可能影响需要住院治疗的严重COVID-19患者的临床和生物学行为。在这里，我们描述了临床和生物学特征，包括在122名实验室确诊为COVID-19的住院患者（55%需要OTI）中筛选CHIP突变体。我们发现，入院时白色细胞计数升高，尤其是中性粒细胞和C反应蛋白（CRP）水平升高，与OTI需求增加相关。我们注意到CH的患病率较高（80岁患者的患病率分别为25%、38%、56%和82%），相比之下，使用相同管道探索的无血液学恶性肿瘤患者的回顾性队列（10%、21%、37%和44%）。然而，CH的存在并没有显著影响临床结果，包括OTI或死亡，并且与其他实验室检查结果无关。
Advanced age or preexisting comorbidities have been characterized as risk factors for severe coronavirus disease 2019 (COVID-19) cases requiring hospitalization and intensive care. In recent years, clonal hematopoiesis (CH) of indeterminate potential (CHIP) has emerged as a risk factor for chronic inflammatory background and subsequent aging-associated diseases. The purpose of this study was to identify biological factors (particularly leukocyte subtypes and inflammatory markers) associated with a risk of clinical deterioration (i.e., orotracheal intubation (OTI)) and to determine whether CH was likely to influence clinical and biological behavior in patients with severe COVID-19 requiring hospitalization. Here, we describe clinical and biological features, including the screening of CHIP mutants in a well-annotated cohort of 122 hospitalized patients with a laboratory-confirmed diagnosis of COVID-19 (55% requiring OTI). We showed that elevated white blood cell counts, especially neutrophils and high C-reactive protein (CRP) levels at admission, were associated with an increased requirement of OTI. We noticed a high prevalence of CH (25%, 38%, 56%, and 82% of patients aged 80 years) compared to a retrospective cohort of patients free of hematological malignancy explored with the same pipelines (10%, 21%, 37%, and 44%). However, the existence of CH did not significantly impact clinical outcome, including OTI or death, and did not correlate with other laboratory findings.