PB0889 - Quantitative Comparison of Immunological and Platelet Markers to develop a mortality risk evaluation scoring system in COVID-19 (MRES-COVID-19)

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

SB

Siobhan L. Branfield

PhD Candidate
Oakland University
Auburn hills, Michigan, United States

Co-Author(s)

ZB

Zaida Bayrón-Marrero

Graduate Student
University of Puerto Rico
San Juan, Puerto Rico, United States
BN

Benjamín Nieves-López

Medical Student
University of Puerto Rico
San Juan, Puerto Rico, United States
SL

Susan Lagrand

Graduate Student
Oakland University
Rochester Hills, Michigan, United States
AF

Angelina Franceschini

Doctor
Univeristy of Medicine
San Juan, Puerto Rico, United States
Matthew T. Rondina, MD

Professor
Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; 4George E. Wahlen Department of Veterans Affairs Medical Center, Geriatric Research, Education, and Clinical Center; Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
Salt Lake City, Utah, United States
MP

Matthew Poynter

Professor of Medicine
University of Vermont
Burlington, Vermont, United States
Robert A. Campbell, PhD

Professor
Washington University , Missouri, United States
VW

Valance Washington

Professor
Oakland University
Rochester, Michigan, United States

Background: The COVID-19 Pandemic resulted in approximately 6,972,152 reported global deaths. Although the precise disease progression mechanisms remain unclear, multiple studies have indicated that a hyperimmune response, evidenced by heightened plasma cytokine levels, comorbidities, and thromboembolic events, increases the risk of mortality in COVID-19 patients

Aims: To determine whether an association between platelet activation markers and plasma cytokines could be used to predict disease severity and mortality risk in COVID-19.

Methods: Plasma cytokine kit and platelet activation marker ELISA kits were used to address the above aim.

Results: All COVID-19 patients showed heightened cytokine and platelet activation marker levels, however, the most significant differences were observed in COVID ICU patients, notably in patients with 2, 3, or more comorbidities. TNF- and IL-6 were particularly raised in patients with 2, 3, or more comorbidities, suggesting an intensified proinflammatory immune response. Prothrombotic and inflammatory markers (S100A8, IL10, D-Dimers, TPO) were linked to mortality in ICU patients. P-Selectin levels significantly correlated with proinflammatory markers S1000A8, C5A, IL1-B, GM-CSF, IFNalpha and procoagulant markers such as D-Dimers and TPO. Increased Trem-Like Transcript-1 (s-TLT-1), a marker of platelet activation, correlated with 2, 3, or more comorbidities, S100A8, IL10, and D-Dimers. Using receiver operator curve (ROC) analysis to establish cutoff points as predictive indicators for mortality in ICU COVID-19, s-TLT-1 demonstrated to be the strongest predictive indicator (with a cutoff of 605pg/ml, a specificity of 0.833 and sensitivity of 0.75), while P-Selectin, IL-10, D-Dimers and S1000A8 have a high sensitivity but not specificity.

Conclusion(s): Here we introduce the potential for a mortality risk evaluation scoring system in COVID-19 (MRES-COVID-19), where parameters include hypertension, ischemic events, s-TLT-1 levels above 605pg/ml, elevated D-Dimers, elevated IL10, and/or concurrence of two or more co-morbidities, where the risk for mortality increases with coexistence of these parameters, and the higher the score the greater the risk of mortality.