Pranav Tadikonda, n/a
Student
University of Pennsylvania, United States
Disclosure information not submitted.
Krzysztof Laudanski, MD, PhD, FCCM
University of Pennsylvania
Philadelphia, Pennsylvania
Disclosure information not submitted.
Title: Use of Urinary Immunological Biomarkers to Assess Immunomodulating Effect of COVID-19 Treatment
Background: In the past, few studies have utilized urine to assess the state of the immune system. Here, we hypothesize that urine biomarkers can assess immune activation and the effect of antiviral treatment in patients infected with COVID-19.
Methods: This was a cross-sectional study involving 68 patients. Blood and urine samples were collected within 48 hours of hospital admission (H1), followed by 96 hours (H2), seven days (H3), and up to 25 days (H4) from admission. Serum levels of ferritin, procalcitonin and IL-6 assessed overall immune activation, while the response to viral burden was gauged with serum levels of spike protein, and α-spike proteins IgM and IgG. A targeted panel of immunological biomarkers was tested in urine using O-link technique.
Results: Several markers correlated highly between urine and blood. Severity of the illness correlated with urine markers as higher urinary levels of IL-12 and lower CAIX, CCL23, IL-15, IL-18, MCP-1, MCP-3, MUC-16, PD-L1, TNFRS12A, and TNFRS21 identified non-survivors. APACHE II scores showed strong correlation with TNFRS21, PGF, CAIX, DCN, CXCL6, and EGF in urine. The urine levels of LAG-3 and IL-2 at admission predicted death. With regards to treatments, Remdesivir had a more profound impact on the urine biomarkers than steroids.
Conclusions: Urinary biomarkers correlated with clinical status and can be utilized for assessment of the treatment effect on immune system performance.