학술논문
C-C motive chemokine ligand 2 and thromboinflammation in COVID-19-associated pneumonia: A retrospective study.
Document Type
Article
Author
Nieri, Dario; Neri, Tommaso; Barbieri, Greta; Moneta, Sara; Morelli, Giovanna; Mingardi, Desirè; Spinelli, Stefano; Ghiadoni, Lorenzo; Falcone, Marco; Tiseo, Giusy; Menichetti, Francesco; Franzini, Maria; Caponi, Laura; Paolicchi, Aldo; Pancani, Roberta; Pistelli, Francesco; Carrozzi, Laura; Celi, Alessandro
Source
Subject
*COVID-19
*TREATMENT effectiveness
*PROGNOSIS
*PNEUMONIA
*RESPIRATORY insufficiency
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Language
ISSN
0049-3848
Abstract
A derangement of the coagulation process and thromboinflammatory events has emerged as pathologic characteristics of severe COVID-19, characterized by severe respiratory failure. C C motive chemokine ligand 2 (CCL2), a chemokine originally described as a chemotactic agent for monocytes, is involved in inflammation, coagulation activation and neoangiogenesis. We investigated the association of CCL2 levels with coagulation derangement and respiratory impairment in patients with COVID-19. We retrospectively evaluated 281 patients admitted to two hospitals in Italy with COVID-19. Among them, CCL2 values were compared in different groups (identified according to D-dimer levels and the lowest PaO 2 /FiO 2 recorded during hospital stay, P/F nadir) by Jonckheere-Terpstra tests; linear regression analysis was used to analyse the relationship between CCL2 and P/F nadir. We performed Mann-Whitney test and Kaplan-Meier curves to investigate the role of CCL2 according to different clinical outcomes (survival and endotracheal intubation [ETI]). CCL2 levels were progressively higher in patients with increasing D-dimer levels and with worse gas exchange impairment; there was a statistically significant linear correlation between log CCL2 and log P/F nadir. CCL2 levels were significantly higher in patients with unfavourable clinical outcomes; Kaplan-Meier curves for the composite outcome death and/or need for ETI showed a significantly worse prognosis for patients with higher (> median) CCL2 levels. CCL2 correlates with both indices of activation of the coagulation cascade and respiratory impairment severity, which are likely closely related in COVID-19 pathology, thus suggesting that CCL2 could be involved in the thromboinflammatory events characterizing this disease. • CCL2 (also known as MCP-1) is involved in inflammation, angiogenesis, coagulation • CCL2 can play a role in thromboinflammatory events in severe COVID-19 • Increasing CCL2 levels correlate with D-dimer in COVID-19 • Circulating CCL2 is associated with respiratory impairment severity in COVID-19 • CCL2 is associated with unfavourable clinical outcomes in COVID-19 patients [ABSTRACT FROM AUTHOR]