Correlations of Myeloperoxidase (MPO), Adenosine deaminase (ADA), C-C motif chemokine 22 (CCL22), Tumour necrosis factor alpha (TNFα) and Interleukin-6 (IL-6) mRNA expression in the nasopharyngeal specimens with the diagnosis and severity of SARS-CoV-2 infections

Emerg Microbes Infect. 2023 Dec;12(1):2157338. doi: 10.1080/22221751.2022.2157338.

Abstract

Cytokine dynamics in patients with coronavirus disease 2019 (COVID-19) have been studied in blood but seldomly in respiratory specimens. We studied different cell markers and cytokines in fresh nasopharyngeal swab specimens for the diagnosis and for stratifying the severity of COVID-19. This was a retrospective case-control study comparing Myeloperoxidase (MPO), Adenosine deaminase (ADA), C-C motif chemokine ligand 22 (CCL22), Tumour necrosis factor alpha (TNFα) and Interleukin-6 (IL-6) mRNA expression in 490 (327 patients and 163 control) nasopharyngeal specimens from 317 (154 COVID-19 and 163 control) hospitalized patients. Of the 154 COVID-19 cases, 46 died. Both total and normalized MPO, ADA, CCL22, TNFα, and IL-6 mRNA expression levels were significantly higher in the nasopharyngeal specimens of infected patients when compared with controls, with ADA showing better performance (OR 5.703, 95% CI 3.424-9.500, p < 0.001). Receiver operating characteristics (ROC) curve showed that the cut-off value of normalized ADA mRNA level at 2.37 × 10-3 had a sensitivity of 81.8% and specificity of 83.4%. While patients with severe COVID-19 had more respiratory symptoms, and elevated lactate dehydrogenase, multivariate analysis showed that severe COVID-19 patients had lower CCL22 mRNA (OR 0.211, 95% CI 0.060-0.746, p = 0.016) in nasopharyngeal specimens, while lymphocyte count, C-reactive protein, and viral load in nasopharyngeal specimens did not correlate with disease severity. In summary, ADA appears to be a better biomarker to differentiate between infected and uninfected patients, while CCL22 has the potential in stratifying the severity of COVID-19.

Keywords: CCL22; COVID-19 severity; Nasopharyngeal specimen; adenosine deaminase; myeloperoxidase.

MeSH terms

  • Adenosine Deaminase / analysis
  • Adenosine Deaminase / genetics
  • Adenosine Deaminase / metabolism
  • COVID-19* / diagnosis
  • Case-Control Studies
  • Chemokine CCL22
  • Chemokines
  • Cytokines
  • Humans
  • Interleukin-6 / genetics
  • Ligands
  • Nasopharynx
  • Peroxidase
  • Retrospective Studies
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / metabolism
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Adenosine Deaminase
  • Peroxidase
  • Ligands
  • Cytokines
  • Chemokines
  • CCL22 protein, human
  • Chemokine CCL22

Grants and funding

This study was partly supported by funding to The University of Hong Kong: from the Health and Medical Research Fund (CID-HKU1-2), the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region; Health@InnoHK, Innovation and Technology Commission, the Government of the Hong Kong Special Administrative Region; the Theme-Based Research Scheme of the Research Grants Council (T11-709/21-N), the Research Grants Council of the Hong Kong Special Administrative Region; the Consultancy Service for Enhancing Laboratory Surveillance of Emerging Infectious Diseases and Research Capability on Antimicrobial Resistance for Department of Health of the Hong Kong Special Administrative Region Government; Sanming Project of Medicine in Shenzhen, China (SZSM201911014); the High Level-Hospital Program, Health Commission of Guangdong Province, China; Emergency Collaborative Project (EKPG22-01) of Guangzhou Laboratory; and Emergency COVID-19 Project (2021YFC0866100), Major Projects on Public Security, National Key Research and Development Program; and donations from Richard Yu and Carol Yu, May Tam Mak Mei Yin, Michael Seak-Kan Tong, the Shaw Foundation Hong Kong, Lee Wan Keung Charity Foundation Limited, Providence Foundation Limited (in memory of the late Lui Hac Minh), Hong Kong Sanatorium & Hospital, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, The Chen Wai Wai Vivien Foundation Limited, Chan Yin Chuen Memorial Charitable Foundation, Marina Man-Wai Lee, the Jessie & George Ho Charitable Foundation, Perfect Shape Medical Limited, Kai Chong Tong, Tse Kam Ming Laurence, Foo Oi Foundation Limited, Betty Hing-Chu Lee, and Ping Cham So. The funding sources had no role in the study design, data collection, analysis, interpretation, or writing of the report.