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Validation of Inflammopathic, Adaptive, and Coagulopathic Sepsis Endotypes in Coronavirus Disease 2019.
Sweeney, Timothy E; Liesenfeld, Oliver; Wacker, James; He, Yudong D; Rawling, David; Remmel, Melissa; Coyle, Sabrina; Midic, Uros; Kotsaki, Antigone; Kanavou, Aggeliki; Leventogiannis, Konstantinos; Kontogeorgou, Ioanna; Giamarellos-Bourboulis, Evangelos J.
  • Sweeney TE; Inflammatix, Burlingame, CA.
  • Liesenfeld O; Inflammatix, Burlingame, CA.
  • Wacker J; Inflammatix, Burlingame, CA.
  • He YD; Inflammatix, Burlingame, CA.
  • Rawling D; Inflammatix, Burlingame, CA.
  • Remmel M; Inflammatix, Burlingame, CA.
  • Coyle S; Inflammatix, Burlingame, CA.
  • Midic U; Inflammatix, Burlingame, CA.
  • Kotsaki A; 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
  • Kanavou A; 1st Department of Pulmonary Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
  • Leventogiannis K; 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
  • Kontogeorgou I; 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
  • Giamarellos-Bourboulis EJ; 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Crit Care Med ; 49(2): e170-e178, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-930107
Semantic information from SemMedBD (by NLM)
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Subject
CD69 protei
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ASSOCIATED_WITH
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C5203670
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
Object
Patients
3. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
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PROCESS_OF
Object
Patients
4. Immune COEXISTS_WITH Viremia
Subject
Immune
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COEXISTS_WITH
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Viremia
5. Immune COEXISTS_WITH Bacterial sepsis
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Immune
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COEXISTS_WITH
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Bacterial sepsis
6. CD69 protein, human|CD69 ASSOCIATED_WITH COVID-19
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CD69 protein, human|CD69
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ASSOCIATED_WITH
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COVID-19
7. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
Object
Patients
8. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
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PROCESS_OF
Object
Patients
9. Immune COEXISTS_WITH Viremia
Subject
Immune
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COEXISTS_WITH
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Viremia
10. Immune COEXISTS_WITH Bacterial sepsis
Subject
Immune
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COEXISTS_WITH
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Bacterial sepsis
ABSTRACT

OBJECTIVES:

Complex critical syndromes like sepsis and coronavirus disease 2019 may be composed of underling "endotypes," which may respond differently to treatment. The aim of this study was to test whether a previously defined bacterial sepsis endotypes classifier recapitulates the same clinical and immunological endotypes in coronavirus disease 2019.

DESIGN:

Prospective single-center observational cohort study.

SETTING:

Patients were enrolled in Athens, Greece, and blood was shipped to Inflammatix (Burlingame, CA) for analysis. PATIENTS Adult patients within 24 hours of hospital admission with coronavirus disease 2019 confirmed by polymerase chain reaction and chest radiography.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

We studied 97 patients with coronavirus disease 2019, of which 50 went on to severe respiratory failure (SRF) and 16 died. We applied a previously defined 33-messenger RNA classifier to assign endotype (Inflammopathic, Adaptive, or Coagulopathic) to each patient. We tested endotype status against other clinical parameters including laboratory values, severity scores, and outcomes. Patients were assigned as Inflammopathic (29%), Adaptive (44%), or Coagulopathic (27%), similar to our prior study in bacterial sepsis. Adaptive patients had lower rates of SRF and no deaths. Coagulopathic and Inflammopathic endotypes had 42% and 18% mortality rates, respectively. The Coagulopathic group showed highest d-dimers, and the Inflammopathic group showed highest C-reactive protein and interleukin-6 levels.

CONCLUSIONS:

Our predefined 33-messenger RNA endotypes classifier recapitulated immune phenotypes in viral sepsis (coronavirus disease 2019) despite its prior training and validation only in bacterial sepsis. Further work should focus on continued validation of the endotypes and their interaction with immunomodulatory therapy.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Sepsis / SARS-CoV-2 / COVID-19 Subject: Sepsis / SARS-CoV-2 / COVID-19 Type of study: Observational study Language: English Journal: Crit Care Med Clinical aspect: Diagnosis / Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Sepsis / SARS-CoV-2 / COVID-19 Subject: Sepsis / SARS-CoV-2 / COVID-19 Type of study: Observational study Language: English Journal: Crit Care Med Clinical aspect: Diagnosis / Etiology Year: 2021
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