Evidence map›Paper›PMID 36482978›Full record

ArticlemedRxiv : the preprint server for health sciences2022

Trajectories of host-response biomarkers and inflammatory subphenotypes in COVID-19 patients across the spectrum of respiratory support.

Michael Lu, Callie Drohan, William Bain, Faraaz A Shah, Matthew Bittner, John Evankovich, Niall Prendergast, Matthew Hensley, Tomeka Suber, Meghan Fitzpatrick and 20 more

Open access · greenAbstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 2 institutions in 1 country.

Michael LuInternal Medicine Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Callie DrohanInternal Medicine Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
William BainDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Faraaz A ShahDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Matthew BittnerInternal Medicine Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
John EvankovichDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Niall PrendergastDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Matthew HensleyDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Tomeka SuberDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Meghan FitzpatrickDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Raj RamananDepartment of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Holt MurrayDepartment of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Caitlin SchaeferDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Shulin QinDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Xiaohong WangDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Yingze ZhangDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Seyed M NouraieDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Heather GentryDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Cathy KessingerDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Asha PatelCenter for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, USA.
Bernard J MacatangayDivision of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA.
Jana JacobsDivision of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA.
John MellorsDivision of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA.
Janet S LeeDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Prabir RayDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Anuradha RayDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Barbara MethéDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Alison MorrisDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Bryan J McVerryDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Georgios D KitsiosDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
University of Pittsburgh · USUniversity of Pittsburgh Medical Center · US

Funding

Microbiome-based diagnosis of pneumonia in the acute respiratory distress syndromeK23HL139987 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KITSIOS, GEORGIOS · 2018 to 2022
$806k
Microbial Determinants of Acute Respiratory Distress Syndrome Severity (MiDAS)R03HL162655 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KITSIOS, GEORGIOS · 2022 to 2023
$159k
BLRD VA IK2 BX004886NHLBI NIH HHS K23 HL139987NHLBI NIH HHS R03 HL162655
6 · The paper itself

Abstract

Purpose: Enhanced understanding of the dynamic changes in the dysregulated inflammatory response in COVID-19 may help improve patient selection and timing for immunomodulatory therapies. Methods: We enrolled 323 COVID-19 inpatients on different levels of baseline respiratory support: i) Low Flow Oxygen (37%), ii) Non-Invasive Ventilation or High Flow Oxygen (NIV_HFO, 29%), iii) Invasive Mechanical Ventilation (IMV, 27%), and iv) Extracorporeal Membrane Oxygenation (ECMO, 7%). We collected plasma samples upon enrollment and days 5 and 10 to measure host-response biomarkers. We classified subjects into inflammatory subphenotypes using two validated predictive models. We examined clinical, biomarker and subphenotype trajectories and outcomes during hospitalization. Results: IL-6, procalcitonin, and Angiopoietin-2 were persistently elevated in patients at higher levels of respiratory support, whereas sRAGE displayed the inverse pattern. Patients on NIV_HFO at baseline had the most dynamic clinical trajectory, with 26% eventually requiring intubation and exhibiting worse 60-day mortality than IMV patients at baseline (67% vs. 35%, p<0.0001). sRAGE levels predicted NIV failure and worse 60-day mortality for NIV_HFO patients, whereas IL-6 levels were predictive in IMV or ECMO patients. Hyper-inflammatory subjects at baseline (<10% by both models) had worse 60-day survival (p<0.0001) and 50% of them remained classified as hyper-inflammatory on follow-up sampling at 5 days post-enrollment. Receipt of combined immunomodulatory therapies (steroids and anti-IL6 agents) was associated with markedly increased IL-6 and lower Angiopoietin-2 levels (p<0.05). Conclusions: Longitudinal study of systemic host responses in COVID-19 revealed substantial and predictive inter-individual variability, influenced by baseline levels of respiratory support and concurrent immunomodulatory therapies.

Indexed as

acute lung injurybiomarkersCOVID-19longitudinalsubphenotypes

Identifiers

PMID36482978
PMCPMC9727768
OpenAlexW4310368230

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.