Pilot study for immunoglobulin E as a prognostic biomarker in coronavirus disease 2019

Abstract

Background Laboratory biomarkers to estimate the severity of COVID‐19 are crucial during the pandemic, since resource allocation must be carefully planned. Aim In the present study, we aim to evaluate the effects of basal serum total immunoglobulin E (IgE) levels and changes in inflammatory parameters on the clinical progression of patients hospitalized with COVID‐19. Methods Patients hospitalized with confirmed COVID‐19 were included in the study. Laboratory data and total IgE levels were measured upon admission. Lymphocyte, eosinophil, ferritin, d‐dimer and CRP parameters were recorded on the baseline and on the 3 rd and 14 th days of hospitalization. Results The study enrolled 202 patients, of which 102(50.5%) were males. The average age was 50.17 ± 19.68. Of the COVID‐19 patients, 41 (20.3%) showed clinical progression. Serum total IgE concentrations were markedly higher (172.90 [0‐2124] vs 38.70 [0‐912], p<0.001) and serum eosinophil levels were significantly lower (0.015 [0‐1.200] vs 0.040 [0‐1.360], p=0.002) in clinically worsened COVID‐19 patients when compared to stable patients. The optimal cut‐off for predicting clinical worsening was 105.2 ng/L; with 61% sensitivity, 82% specificity, 46.3% positive predictive value and 89.2% negative predictive value (area under the curve=0.729). Multivariable analysis to define risk factors for disease progression identified higher total IgE and CRP levels as independent predictors. Conclusions Our single‐center pilot study determined that total IgE levels may be a negative prognostic factor for clinical progression in patients hospitalized due to COVID‐19 infection. Future studies are required to determine the impact of individuals' underlying immune predispositions on outcomes of COVID‐19 infections. This article is protected by copyright. All rights reserved.

HERV-W ENV antigenemia and correlation of increased anti-SARS-CoV-2 immunoglobulin levels with post-COVID-19 symptoms

“…Both anti-spike and anti-nucleocapsid IgE antibodies were significantly increased when compared to pre-pandemic controls (p<0.01 and p<0.0001, respectively; Figure 2D ). These results highlight that a subgroup of post-COVID-19 condition patients present a sustained immune response against SARS-CoV-2 antigens, with IgG, IgA and IgE levels similar or even increased when compared to those observed during active COVID-19 infections ( 23 , 24 ).…”

“…On another end, the study of antibody response to SARS-CoV-2 by screening virus antigen microarrays revealed that early IgA and IgG responses can constitute markers of acute disease severity ( 23 ). In addition, it was found that SARS-CoV-2 elicits IgE responses with levels positively correlating with severity thus suggesting a link between SARS-CoV-2 infection, degree of severity with mast cell activation ( 23 , 24 ).…”

Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis

“…After that, 300 articles were evaluated for full-text eligibility, and 197 articles with available data but not Asian were excluded. Ultimately, 103 studies conducted in Asia were enrolled in this meta-analysis [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ,…”

Immune repertoire sequencing reveals an abnormal adaptive immune system in COVID‐19 survivors

“…Very few studies have focused on the serum levels of IgE in COVID‐19 patients. Only one recent report pointed out that more severe COVID‐19 patients had higher levels of IgE 32 . In addition, IgE is a key player in airway disease, 33 which is unlikely to be associated with SARS‐CoV‐2‐specific reactions but a consequence of airway inflammation.…”