ArticleInnate immunity2021
Circulating cell-free DNA, peripheral lymphocyte subsets alterations and neutrophil lymphocyte ratio in assessment of COVID-19 severity.
Article in Innate immunity, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 87 citations in OpenAlex.
- Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis.Disease markers · 2021Pooled it
- Multiparametric profiling of plasma cell-free nucleic acids in nonagenarians and centenarians highlights age-related differences associated with longevity.GeroScience · 2026Article
- Cell-free nucleic acids as a non-invasive biomarker for predicting COVID-19 disease severity and outcome: a retrospective cohort study.BMC infectious diseases · 2026Article
- Quantifying endothelial damage by digital droplet polymerase chain reaction (PCR) of endothelial cell-free DNA in COVID-19 patients.Research and practice in thrombosis and haemostasis · 2026Article
- A feedback loop between DNA damage, genomic instability, and cytoplasmic DNA sensing contributes to cytokine production in COVID-19.Archives of virology · 2025Review
- Extracellular DNA, hyaluronic acid, HIF pathways, and LncRNAs as predictive biomarkers of severe COVID-19.Virology journal · 2025Review
- Novel Biomarkers for SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis.Journal of personalized medicine · 2025Review
- Cell-free DNA Levels in Herpes Zoster: A Cross-sectional Longitudinal Study.Acta dermato-venereologica · 2025Article
- Increased levels of circulating cell-free DNA in COVID-19 patients with respiratory failure.Scientific reports · 2024Article
- What is the actual relationship between neutrophil extracellular traps and COVID-19 severity? A longitudinal study.Respiratory research · 2024Article
- The Diagnostic, Prognostic, and Therapeutic Potential of Cell-Free DNA with a Special Focus on COVID-19 and Other Viral Infections.International journal of molecular sciences · 2023Review
- Exploring the Synergistic Potential of Radiomics and Laboratory Biomarkers for Enhanced Identification of Vulnerable COVID-19 Patients.Microorganisms · 2023Article
- Plasma cell-free DNA promise monitoring and tissue injury assessment of COVID-19.Molecular genetics and genomics : MGG · 2023Article
- IL-6 and cfDNA monitoring throughout COVID-19 hospitalization are accurate markers of its outcomes.Respiratory research · 2023Article
- Article
- Circulating cell-free DNA in health and disease - the relationship to health behaviours, ageing phenotypes and metabolomics.GeroScience · 2023Article
- Analysis of the Influencing Factors of Tumor Volume, Body Immunity, and Poor Prognosis afterMediators of inflammation · 2023Article
- Self-DNA driven inflammation in COVID-19 and after mRNA-based vaccination: lessons for non-COVID-19 pathologies.Frontiers in immunology · 2023Article
- Observational
- Biomarkers of cell damage, neutrophil and macrophage activation associated with in-hospital mortality in geriatric COVID-19 patients.Immunity & ageing : I & A · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cell destruction results in plasma accumulation of cell-free DNA (cfDNA). Dynamic changes in circulating lymphocytes are features of COVID-19. We aimed to investigate if cfDNA level can serve in stratification of COVID-19 patients, and if cfDNA level is associated with alterations in lymphocyte subsets and neutrophil-to-lymphocyte ratio (NLR). This cross-sectional comparative study enrolled 64 SARS-CoV-2-positive patients. Patients were subdivided to severe and non-severe groups. Plasma cfDNA concentration was determined by real-time quantitative PCR. Lymphocyte subsets were assessed by flow cytometry. There was significant increase in cfDNA among severe cases when compared with non-severe cases. cfDNA showed positive correlation with NLR and inverse correlation with T cell percentage. cfDNA positively correlated with ferritin and C-reactive protein. The output data of performed ROC curves to differentiate severe from non-severe cases revealed that cfDNA at cut-off ≥17.31 ng/µl and AUC of 0.96 yielded (93%) sensitivity and (73%) specificity. In summary, excessive release of cfDNA can serve as sensitive COVID-19 severity predictor. There is an association between cfDNA up-regulation and NLR up-regulation and T cell percentage down-regulation. cfDNA level can be used in stratification and personalized monitoring strategies in COVID-19 patients.
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Registered trials
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