Clinico-Biological Features and Clonal Hematopoiesis in Patients with Severe COVID-19
Open Access
- 20 July 2020
- Vol. 12 (7), 1992
- https://doi.org/10.3390/cancers12071992
Abstract
Advanced age or preexisting comorbidities have been characterized as risk factors for severe coronavirus disease 2019 (COVID-19) cases requiring hospitalization and intensive care. In recent years, clonal hematopoiesis (CH) of indeterminate potential (CHIP) has emerged as a risk factor for chronic inflammatory background and subsequent aging-associated diseases. The purpose of this study was to identify biological factors (particularly leukocyte subtypes and inflammatory markers) associated with a risk of clinical deterioration (i.e., orotracheal intubation (OTI)) and to determine whether CH was likely to influence clinical and biological behavior in patients with severe COVID-19 requiring hospitalization. Here, we describe clinical and biological features, including the screening of CHIP mutants in a well-annotated cohort of 122 hospitalized patients with a laboratory-confirmed diagnosis of COVID-19 (55% requiring OTI). We showed that elevated white blood cell counts, especially neutrophils and high C-reactive protein (CRP) levels at admission, were associated with an increased requirement of OTI. We noticed a high prevalence of CH (25%, 38%, 56%, and 82% of patients aged 80 years) compared to a retrospective cohort of patients free of hematological malignancy explored with the same pipelines (10%, 21%, 37%, and 44%). However, the existence of CH did not significantly impact clinical outcome, including OTI or death, and did not correlate with other laboratory findings.Keywords
Funding Information
- Agence Nationale de la Recherche (I-SITE ULNE/ANR-16-IDEX-0004 ULNE)
This publication has 24 references indexed in Scilit:
- An inflammatory environment containing TNF alpha favors Tet2-mutant clonal hematopoiesisExperimental Hematology, 2018
- Tet2-Mediated Clonal Hematopoiesis Accelerates Heart Failure Through a Mechanism Involving the IL-1β/NLRP3 InflammasomeJournal of the American College of Cardiology, 2018
- Tet2 restrains inflammatory gene expression in macrophagesExperimental Hematology, 2017
- DNMT3A and TET2 dominate clonal hematopoiesis and demonstrate benign phenotypes and different genetic predispositionsBlood, 2017
- Clonal hematopoiesis, with and without candidate driver mutations, is common in the elderlyBlood, 2017
- Clonal Hematopoiesis and Risk of Atherosclerotic Cardiovascular DiseaseNew England Journal of Medicine, 2017
- Methyltransferase Dnmt3a upregulates HDAC9 to deacetylate the kinase TBK1 for activation of antiviral innate immunityNature Immunology, 2016
- Tet2 is required to resolve inflammation by recruiting Hdac2 to specifically repress IL-6Nature, 2015
- Clonal Hematopoiesis and Blood-Cancer Risk Inferred from Blood DNA SequenceNew England Journal of Medicine, 2014
- Age-Related Clonal Hematopoiesis Associated with Adverse OutcomesNew England Journal of Medicine, 2014