Interplay of inflammatory markers and anti-SARS-CoV-2 antibodies in COVID-19 mortality : A prospective cohort study
Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: Despite high global vaccination coverage, it remains unclear how vaccination and anti-SARS-CoV-2 antibodies affect immune responses and inflammation levels in patients with COVID-19. It is further unclear whether the inflammatory response differs depending on antibody levels and whether the combination of antibody and inflammation levels in COVID-19 patients affects mortality rates.
METHODS: We conducted a prospective multicenter cohort study that included 1031 hospitalized COVID-19 patients from five hospitals. Anti-SARS-CoV-2-spike antibodies, interleukin-6 (IL6), and CRP were measured on hospital admission. The prespecified endpoint was all-cause in-hospital mortality.
RESULTS: We observed significantly lower levels of CRP (P<0.001) and IL6 (P<0.001) in patients with antibody levels above 1200 BAU/ml. After adjusting for potential confounders, patients with high levels of inflammatory markers (CRP>6 mg/dl or IL6>100 pg/ml) combined with low levels of anti-SARS-CoV-2-spike antibodies (<1200 BAU/ml) were approximately 8 times more likely to die than patients with low inflammatory responses and high antibody levels (CRP: aHR 7.973, 95% CI 2.744-23.169, P<0.001; IL6: aHR 8.973, 95% CI 3.549-22.688, P<0.001).
CONCLUSION: Hospitalized COVID-19 patients presenting with high inflammatory markers and low antibody levels exhibited the highest mortality risks. Higher antibody levels are associated with lower levels of inflammation in hospitalized COVID-19 patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:143 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 143(2024) vom: 22. März, Seite 107016 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mink, Sylvia [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-SARS-CoV-2 spike antibodies |
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| Anmerkungen: |
Date Revised 13.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.ijid.2024.107016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370110102 |
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| 100 | 1 | |a Mink, Sylvia |e verfasserin |4 aut | |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Despite high global vaccination coverage, it remains unclear how vaccination and anti-SARS-CoV-2 antibodies affect immune responses and inflammation levels in patients with COVID-19. It is further unclear whether the inflammatory response differs depending on antibody levels and whether the combination of antibody and inflammation levels in COVID-19 patients affects mortality rates | ||
| 520 | |a METHODS: We conducted a prospective multicenter cohort study that included 1031 hospitalized COVID-19 patients from five hospitals. Anti-SARS-CoV-2-spike antibodies, interleukin-6 (IL6), and CRP were measured on hospital admission. The prespecified endpoint was all-cause in-hospital mortality | ||
| 520 | |a RESULTS: We observed significantly lower levels of CRP (P<0.001) and IL6 (P<0.001) in patients with antibody levels above 1200 BAU/ml. After adjusting for potential confounders, patients with high levels of inflammatory markers (CRP>6 mg/dl or IL6>100 pg/ml) combined with low levels of anti-SARS-CoV-2-spike antibodies (<1200 BAU/ml) were approximately 8 times more likely to die than patients with low inflammatory responses and high antibody levels (CRP: aHR 7.973, 95% CI 2.744-23.169, P<0.001; IL6: aHR 8.973, 95% CI 3.549-22.688, P<0.001) | ||
| 520 | |a CONCLUSION: Hospitalized COVID-19 patients presenting with high inflammatory markers and low antibody levels exhibited the highest mortality risks. Higher antibody levels are associated with lower levels of inflammation in hospitalized COVID-19 patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Anti-SARS-CoV-2 spike antibodies | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a CRP | |
| 650 | 4 | |a Infection markers | |
| 650 | 4 | |a Inflammation | |
| 650 | 4 | |a Interleukin 6 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a Vaccination | |
| 650 | 4 | |a correlate of protection | |
| 700 | 1 | |a Drexel, Heinz |e verfasserin |4 aut | |
| 700 | 1 | |a Leiherer, Andreas |e verfasserin |4 aut | |
| 700 | 1 | |a Frick, Matthias |e verfasserin |4 aut | |
| 700 | 1 | |a Reimann, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Saely, Christoph H |e verfasserin |4 aut | |
| 700 | 1 | |a Fraunberger, Peter |e verfasserin |4 aut | |
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