Abstract
Background and Objectives: African Americans and males have elevated risks of infection, hospitalization, and death from SARS-CoV-2 in comparison with other populations. We report immune responses and renal injury markers in African American male patients hospitalized for COVID-19. Methods: This was a single-center, retrospective study of 56 COVID-19 infected hospitalized African American males 50+ years of age selected from among non-intensive care unit (ICU) and ICU status patients. Demographics, hospitalization-related variables, and medical history were collected from electronic medical records. Plasma samples collected close to admission (≤2 days) were evaluated for cytokines and renal markers; results were compared to a control group (n = 31) and related to COVID-19 in-hospital mortality. Results: Among COVID-19 patients, eight (14.2%) suffered in-hospital mortality; seven (23.3%) in the ICU and one (3.8%) among non-ICU patients. Interleukin (IL)-18 and IL-33 were elevated at admission in COVID-19 patients in comparison with controls. IL-6, IL-18, MCP-1/CCL2, MIP-1α/CCL3, IL-33, GST, and osteopontin were upregulated at admission in ICU patients in comparison with controls. In addition to clinical factors, MCP-1 and GST may provide incremental value for risk prediction of COVID-19 in-hospital mortality. Conclusions: Qualitatively similar inflammatory responses were observed in comparison to other populations reported in the literature, suggesting non-immunologic factors may account for outcome differences. Further, we provide initial evidence for cytokine and renal toxicity markers as prognostic factors for COVID-19 in-hospital mortality among African American males.
Highlights
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is the β-coronavirus responsible for the COVID-19 global pandemic, causing millions of infections and deaths
A total of 56 COVID-19-affected and 31 non-COVID-19-affected African American male patients were analyzed (Table 1). Of those with COVID-19, 30 cases were treated in the intensive care unit (ICU) and 26 were hospitalized without requiring ICU care
Four patients were on IL-6 cytokine inhibitors; these were excluded for the analysis of IL-6
Summary
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is the β-coronavirus responsible for the COVID-19 global pandemic, causing millions of infections and deaths (according to the WHO). The immune reaction to SARS-CoV-2 infection can lead to cytokine storm syndrome, with substantial mortality risk [6,7] Inflammatory mediators, such as interleukin (IL) IL-2, IL-7, IL-10, IL-1, IL-6, IL-18, IL-33, tumor necrosis factor (TNF), monocyte chemoattractant protein-1 (MCP-1; known as CCL2), macrophage inflammatory protein 1 alpha (MIP1α; known as CCL3), CXC-chemokine ligand 10 (CXCL10), RANTES ( known as CCL5), C-reactive protein (CRP), ferritin, and D-dimer, are upregulated systemically in severe COVID-19 cases [6,7]. We report immune responses and renal injury markers in African American male patients hospitalized for COVID-19. We provide initial evidence for cytokine and renal toxicity markers as prognostic factors for COVID-19 in-hospital mortality among African American males
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