Early neutrophil responses are potential biomarkers to predict severe COVID-19 in adults
In the early COVID-19 pandemic, the strain on healthcare facilities highlighted the need for reliable biomarkers to predict progression to severe COVID-19. Neutrophils, the most abundant leukocytes in circulation, are early defenders against pathogens. In a Singaporean adult cohort, early neutrophil mediators were assessed for their suitability as prognostic biomarkers of COVID-19 complications. Plasma levels of myeloperoxidase, elastase, soluble urokinase plasminogen activator receptor (suPAR) and soluble suppressor of tumorigenicity 2 (sST2) in 35 non-severe and 14 severe cases were measured twice, 2-7 days apart after hospitalisation. Nineteen controls were included. The levels of MPO, elastase, suPAR and sST2 were significantly higher in patients with severe COVID-19 compared to those with mild and healthy controls. At baseline sampling, MPO and suPAR predicted severe COVID-19 and had AUROCs of 0.76 and 0.87, respectively. MPO and suPAR at cut-off values of 26.41 ng/ml and 3.19 ng/ml, respectively showed approximately 71% sensitivity and 81 - 84% specificity to differentiate severe COVID-19. In contrast, elastase and neutrophil counts were less predictive of severe disease. In adult COVID-19, MPO and suPAR may be reliable prognostic biomarkers of severe disease during acute COVID-19. Further validation of these markers in a larger cohort and in other infectious diseases is warranted.
Authors
- Lova Sun (ORCID: https://orcid.org/0000-0002-5015-2964)
- Seow Yen Tan (ORCID: https://orcid.org/0000-0001-7870-2879)
- Lisa F. P. Ng (ORCID: https://orcid.org/0000-0003-4071-5222)
- Barnaby Edward Young (ORCID: https://orcid.org/0000-0003-1010-2230)
- Louis Yi Ann Chai (ORCID: https://orcid.org/0000-0002-9640-0791)
- David Chien Lye (ORCID: https://orcid.org/0000-0003-0324-0205)
- Nurhidayah Binte Mohamed Yazid
- Siew‐Wai Fong (ORCID: https://orcid.org/0000-0002-5326-489X)
- Keisuke Ejima (ORCID: https://orcid.org/0000-0002-1185-3987)
- Ananya Singh (ORCID: https://orcid.org/0000-0002-9731-7746)
- Shirin Kalimuddin (ORCID: https://orcid.org/0000-0001-9319-5908)
- Raika Francesca Morales
- Laurent Rénia (ORCID: https://orcid.org/0000-0003-0349-1557)
- Andrew Teo (ORCID: https://orcid.org/0000-0002-4520-2701)
- Po Ying Chia (ORCID: https://orcid.org/0000-0002-8797-9527)
- Tsin Wen Yeo (ORCID: https://orcid.org/0000-0002-4060-7902)
Institutions
- Agency for Science, Technology and Research (SG)
- University of Liverpool (GB)
- The University of Melbourne (AU)
- National University of Singapore (SG)
- Nanyang Technological University (SG)
- Alexandra Hospital (SG)
- Changi General Hospital (SG)
- Tan Tock Seng Hospital (SG)
- National Institute of Infectious Diseases (JP)
- Peter Doherty Institute (AU)
- Duke-NUS Medical School (SG)
- National University Health System (SG)
- National Centre for Infectious Diseases (SG)
- Health Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool (GB)
Publication Details
- Journal
- Journal of Leukocyte Biology
- Published
- 2025-03-20
- DOI
- https://doi.org/10.1093/jleuko/qiaf035
- Citations
- 3
- Primary Topic
- COVID-19 Clinical Research Studies
- Type
- article
- Field-Weighted Citation Impact
- 4.19