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Association of soluble PD-L1 and NLR combination with 1-Year mortality in patients with COVID-19
Lyudmila Akhmaltdinova1, Irina Mekhantseva1, Lyudmila Turgunova1
1Karaganda Medical University, Scientific and Research Center, Karaganda, Kazakhstan.
Insights
Combining soluble programmed death ligand-1 (sPD-L1) and Neutrophil-lymphocyte ratio (NLR) significantly improves the prediction of 1-year mortality in COVID-19 patients. This combined marker offers a more accurate assessment of COVID-19 patient outcomes.
Area of Science:
- Immunology
- Infectious Diseases
- Biomarkers
Background:
- COVID-19 severity is linked to immune system dysregulation.
- Elevated soluble programmed death ligand-1 (sPD-L1) and Neutrophil-lymphocyte ratio (NLR) correlate with increased COVID-19 severity.
Purpose of the Study:
- To investigate the combined association of sPD-L1 and NLR with 1-year mortality in COVID-19 patients.
- To determine if combining these immune markers enhances mortality prediction.
Main Methods:
- Prospective study in Karaganda, Kazakhstan.
- sPD-L1 levels measured in blood serum using ELISA.
- Multivariate regression analysis used to assess biomarker impact on mortality.
Main Results:
- Individually, high sPD-L1 (>277.13 pg/ml) and high NLR (>2.46) were associated with increased 1-year mortality risk (HR 2.46 and 2.87, respectively).
- The combined model of sPD-L1 and NLR significantly improved mortality prediction accuracy, yielding a Hazard Ratio of 7.6 (95% CI: 3.02-19.11).
Conclusions:
- The combination of sPD-L1 and NLR provides a synergistic effect in predicting COVID-19 mortality.
- These immune-mediated markers reflect systemic inflammatory balance and can enhance risk assessment for COVID-19 patients.
Purpose:
Understanding the relationship between patient immune characteristics, disease severity, and mortality represents a critical step in the fight against COVID-19. Elevated levels of programmed death ligand-1 (PD-L1) and Neutrophil-lymphocyte ratio (NLR) are linked to increased severity of acute COVID-19 in patients. This study aimed to investigate the association of the combination of sPD-L1 and NLR with 1-year Mortality in patients with COVID-19.
Methods:
A prospective study was conducted involving patients with COVID-19 in Karaganda, Kazakhstan. The level of sPD-L1 in the blood serum was evaluated by ELISA. The effect of biomarkers on the development of mortality was analyzed with multivariate regression.
Results:
The risk of mortality within one year HR was 2.46 if the plasma sPD-L1 value of more than 277.13 pg/ml, and for NLR more than 2.46 HR was 2.87. The model of combining sPD-L1 and NLR resulted in an improvement in the predictive accuracy of the Hazard Ratio 7.6 (95 % CI: 3.02-19.11).
Conclusion:
The combination of two immune-mediated markers (sPD-L1 and NLR), which reflect the systemic inflammatory balance of activation and exhaustion, can complement each other and improve the assessment of the risk of death in patients with COVID-19.
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