Frontiers in Medicine (Sep 2022)

Difference in mortality rates in hospitalized COVID-19 patients identified by cytokine profile clustering using a machine learning approach: An outcome prediction alternative

  • Ana Cristina Castro-Castro,
  • Lucia Figueroa-Protti,
  • Jose Arturo Molina-Mora,
  • María Paula Rojas-Salas,
  • Danae Villafuerte-Mena,
  • María José Suarez-Sánchez,
  • Alfredo Sanabría-Castro,
  • Alfredo Sanabría-Castro,
  • Carolina Boza-Calvo,
  • Leonardo Calvo-Flores,
  • Mariela Solano-Vargas,
  • Juan José Madrigal-Sánchez,
  • Mario Sibaja-Campos,
  • Juan Ignacio Silesky-Jiménez,
  • José Miguel Chaverri-Fernández,
  • Andrés Soto-Rodríguez,
  • Ann Echeverri-McCandless,
  • Sebastián Rojas-Chaves,
  • Denis Landaverde-Recinos,
  • Andreas Weigert,
  • Andreas Weigert,
  • Andreas Weigert,
  • Andreas Weigert,
  • Javier Mora,
  • Javier Mora

DOI
https://doi.org/10.3389/fmed.2022.987182
Journal volume & issue
Vol. 9

Abstract

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COVID-19 is a disease caused by the novel Coronavirus SARS-CoV-2 causing an acute respiratory disease that can eventually lead to severe acute respiratory syndrome (SARS). An exacerbated inflammatory response is characteristic of SARS-CoV-2 infection, which leads to a cytokine release syndrome also known as cytokine storm associated with the severity of the disease. Considering the importance of this event in the immunopathology of COVID-19, this study analyses cytokine levels of hospitalized patients to identify cytokine profiles associated with severity and mortality. Using a machine learning approach, 3 clusters of COVID-19 hospitalized patients were created based on their cytokine profile. Significant differences in the mortality rate were found among the clusters, associated to different CXCL10/IL-38 ratio. The balance of a CXCL10 induced inflammation with an appropriate immune regulation mediated by the anti-inflammatory cytokine IL-38 appears to generate the adequate immune context to overrule SARS-CoV-2 infection without creating a harmful inflammatory reaction. This study supports the concept that analyzing a single cytokine is insufficient to determine the outcome of a complex disease such as COVID-19, and different strategies incorporating bioinformatic analyses considering a broader immune profile represent a more robust alternative to predict the outcome of hospitalized patients with SARS-CoV-2 infection.

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