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Prognostic Value of Peripheral Blood nCD64 Index, mHLA-DR, and CD14+monocyte Percentage in Different Infection Status
Mingli Zhu1, Jianghao Cheng1,2, Lingyan He1
1Open Laboratory, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
Insights
The neutrophil CD64 (nCD64) index, monocytic HLA-DR (mHLA-DR), and CD14+ monocyte percentage can predict COVID-19 patient outcomes. Lower nCD64 and higher mHLA-DR/CD14+ monocytes indicate better prognosis in COVID-19 patients.
Area of Science:
- Immunology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Coronavirus disease 2019 (COVID-19) poses significant global health challenges.
- Identifying reliable biomarkers for predicting COVID-19 prognosis is crucial for patient management.
- Neutrophil CD64 (nCD64) index, monocytic HLA-DR (mHLA-DR), and CD14+ monocyte percentage are potential indicators of immune status.
Purpose of the Study:
- To evaluate the prognostic value of nCD64 index, mHLA-DR, and CD14+ monocyte percentage in COVID-19 patients.
- To determine the predictive accuracy of these biomarkers for clinical outcomes in COVID-19.
Main Methods:
- A cohort of 57 COVID-19 patients was analyzed, categorized into non-severe and severe groups.
- Flow cytometry was used to measure nCD64 index, mHLA-DR, and CD14+ monocyte percentage.
- Receiver operating characteristic (ROC) curve analysis assessed the predictive value of these biomarkers.
Main Results:
- Non-severe COVID-19 patients exhibited significantly higher mHLA-DR and CD14+ monocyte percentages, and lower nCD64 index compared to severe cases.
- Deceased patients showed significantly lower mHLA-DR and CD14+ monocyte percentages, and a higher nCD64 index than survivors.
- The area under the curve (AUC) values were 0.850 for nCD64 index, 0.779 for mHLA-DR, and 0.871 for CD14+ monocyte percentage.
Conclusions:
- The nCD64 index, mHLA-DR level, and percentage of CD14+ monocytes demonstrate significant potential as biomarkers for predicting COVID-19 prognosis.
- Specific thresholds for these markers (CD14+ >4.9%, mHLA-DR >16720.5, nCD64 <5.87) are associated with good prognosis in COVID-19 patients.
Objective:
To explore the value of the neutrophil CD64 (nCD64) index, monocytic HLA-DR (mHLA-DR), and the percentage of CD14+ monocytes in the prognosis of Coronavirus disease 2019 (COVID-19).
Methods:
Fifty-seven COVID-19 patients from December 2022 to November 2023 were divided into two groups: non-severe group (mild or moderate cases) and severe group (severe or critical cases). Among them, 17 patients were deceased. Flow cytometry was employed to detect the levels of nCD64 index, mHLA-DR, and CD14+monocyte percentage in blood. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of mHLA-DR, nCD64 index, and CD14+ monocyte percentage for COVID-19 prognosis.
Results:
The expression levels of mHLA-DR and the percentage of CD14+ monocytes in non-severe COVID-19 patients were significantly higher than those in severe and deceased patients (P < 0.05). In contrast, the nCD64 index in non-severe patients was significantly lower than that in severe and deceased patients (P< 0.05). The expression level of mHLA-DR and the percentage of CD14+ monocytes in deceased patients were significantly lower than those in surviving patients (P<0.001), while the nCD64 index level in surviving patients was significantly lower than that in deceased patients (P<0.001). The area under the curve (AUC) for the nCD64 index, mHLA-DR and the percentage of CD14+ monocytes were 0.850, 0.779 and 0.871, respectively. Patients with CD14+ monocyte percentage > 4.9%, mHLA-DR value >16720.5, and nCD64 index <5.87 had a good prognosis value (P < 0.05).
Conclusion:
The nCD64 index, mHLA-DR level, and percentage of CD14+ monocytes may serve as biomarkers for predicting clinical outcomes in COVID-19 patients.
