Yao Lee, PhD, , DVM
Postdoctoral Associate
n/a
Cambridge, Massachusetts
Disclosure information not submitted.
Ander Dorken Gallastegi, MD
Fellow
Massachusetts General Hospital, United States
Disclosure information not submitted.
Leon Naar, MD
Fellow
Massachusetts General Hospital, United States
Disclosure information not submitted.
Elizabeth Van Cott, MD
Professor of Pathology
Massachusetts General Hospital, United States
Disclosure information not submitted.
Rachel Rosovsky, MD, MPH
Assistant Professor of Medicine
Massachusetts General Hospital
Boston, Massachusetts, United States
Disclosure information not submitted.
David Gregory, PhD
Instructor in Pediatrics
Massachusetts General Hospital, United States
Disclosure information not submitted.
Damodaran Annamalai, DVM, PhD
Research/Clinical Veterinarian
Massachusetts Institute of Technology, United States
Disclosure information not submitted.
Haytham Kaafarani, MD, MPH
Associate Professor of Surgery
Massachusetts General Hospital, United States
Disclosure information not submitted.
George Velmahos, MD, PhD
John F. Burke Professor of Surgery
Massachusetts General Hospital, United States
Disclosure information not submitted.
Jarone Lee, MD, MPH, FCCM
Assistant Professor of Medicine
Massachusetts General Hospital, United States
Disclosure information not submitted.
Galit Frydman, DVM, ScD
Massachusetts General Hospital
Cambridge
Disclosure information not submitted.
Title: Circulating Cellular Clusters Are Correlated With Clinical Outcomes And Demographics In COVID-19.
Introduction: It is known that COVID-19 induces a proinflammatory and prothrombotic state, with certain demographics having higher rates of morbidity and mortality. We have previously shown that COVID-19 infection results in three types of circulating cellular clusters (CCCs) (platelet-erythrocyte aggregates [PEAs], platelet-leucocyte aggregates [PLAs], and leucocyte clusters [LCs]): PLAs, PEAs and LCs are all significantly elevated, LCs correlate with thrombotic events and acute kidney injury, while PEAs are correlated with mechanical ventilation and secondary bacterial infections. The aim of this study was to evaluate whether there was a relationship between patient demographics, CCCs and clinical outcomes.
Methods: Forty-three blood samples of COVID-19 PCR positive patients from a tertiary academic referral center were analyzed via imaging flow cytometry to identify three types of aggregates: PEAs (>1 erythrocyte with platelets), PLAs (1 leucocyte with platelets), and LCs (multiple leucocytes). Unpaired t tests or one-way ANOVA followed by multiple comparison tests were applied to compare the percentage of CCCs in different groups based on demographic factors such as age, race, gender, ethnicity, BMI, and various clinical outcomes.
Results: In COVID-19 patients, those who self-identified as African-Americans (n=11, mean age= 56) had significantly higher LCs than patients who identified as White (n=23, mean age= 56) (p= 0.0358). Patient ethnicity, identifying as Hispanic or non-Hispanic, as well as gender did not appear to be correlated with CCCs. Weight and age also appeared to correlate with CCC phenotype, with overweight (n=11, BMI 25.1-30), and obese (n= 16, BMI >30), patients having higher PLAs (p= 0.0531), and patients over the age of 40 (n=34) having significantly higher LCs (p=0.003).
Conclusions: CCCs appear to be correlated with both clinical outcomes as well as patient demographics in patients with COVID-19. Specific CCC phenotypes may be used to potentially identify patients at higher risk for severe infection and specific adverse outcomes. Additionally, this new information on CCC phenotypes may lead the future discovery of protein and receptor involvement to help understand the pathophysiological mechanisms as well as identify potential precision-medicine-based targeted therapeutics.