The FLARE Score and Circulating Neutrophils in Patients with Cancer and COVID-19 Disease
Seguí, Elia (Hospital Clínic i Provincial de Barcelona)
Torres Canizales, Juan (Hospital Clínic i Provincial de Barcelona)
Auclin, E. (Université Paris Cité)
Casadevall, David (Hospital del Mar (Barcelona, Catalunya))
Peiro Carmona, Sara (Hospital Clínic i Provincial de Barcelona)
Aguilar Company, Juan (Vall d'Hebron Institut d'Oncologia)
García de Herreros, Marta (Hospital Clínic i Provincial de Barcelona)
Gorría, Teresa (Hospital Clínic i Provincial de Barcelona)
Laguna, Juan Carlos (Hospital Clínic i Provincial de Barcelona)
Rodríguez, Marta (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
González, Azucena (Hospital Clínic i Provincial de Barcelona)
Epaillard, N. (Université Paris Cité)
Gavira, Javier (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Bolaño, Victor (Hospital Clínic i Provincial de Barcelona)
Tapia, Jose C. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Tagliamento, M. (IRCCS Ospedale Policlinico San Martino (Gènova, Itàlia))
Teixidó, C. (Universitat de Barcelona)
Arasanz, Hugo (Hospital Universitario de Navarra)
Pilotto, S. (University of Verona and University and Hospital Trust (AOUI) of Verona)
Lopez Castro, Rafael (Hospital Clínico Universitario de Valladolid)
Mielgo-Rubio, Xabier (Hospital Universitario Fundación Alcorcón)
Urbano, C. (Hospital General de Granollers)
Recondo, G. (Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC))
Diaz Pavon, Mar (Hospital Clínic i Provincial de Barcelona)
Bluthgen, M.V. (Hospital Aleman)
Minatta, J.N. (Hospital Italiano de Buenos Aires (Argentina))
Lupinacci, L. (Hospital Italiano de Buenos Aires (Argentina))
Brasó-Maristany, F. (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Prat, A. (Reveal Genomics)
Vlagea, Alexandru (Hospital Clínic i Provincial de Barcelona)
Mezquita, Laura (Universitat de Barcelona)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Inflammation and neutrophils play a central role in both COVID-19 disease and cancer. We aimed to assess the impact of pre-existing tumor-related inflammation on COVID-19 outcomes in patients with cancer and to elucidate the role of circulating neutrophil subpopulations. We conducted a multicenter retrospective analysis of 524 patients with cancer and SARS-CoV-2 infection, assessing the relationship between clinical outcomes and circulating inflammatory biomarkers collected before and during COVID-19 infection. Additionally, a single-center prospective cohort study provided data for an exploratory analysis, assessing the immunophenotype of circulating neutrophils and inflammatory cytokines. The primary endpoints were 30-day mortality and the severity of COVID-19 disease. Prior to COVID-19, 25% of patients with cancer exhibited elevated dNLR, which increased to 55% at the time of COVID-19 diagnosis. We developed the FLARE score, incorporating both tumor- and infection-induced inflammation, which categorized patients into four prognostic groups. The poor prognostic group had a 30-day mortality rate of 68%, significantly higher than the 23% in the favorable group (p < 0. 0001). This score proved to be an independent predictor of early mortality. This prospective analysis revealed a shift towards immature forms of neutrophils and higher IL-6 levels in patients with cancer and severe COVID-19 infection. A pre-existing tumor-induced pro-inflammatory state significantly impacts COVID-19 outcomes in patients with cancer. The FLARE score, derived from circulating inflammatory markers, emerges as an easy-to-use, globally accessible, effective tool for clinicians to identify patients with cancer at heightened risk of severe COVID-19 complications and early mortality who might benefit most from immediate and intensive treatment strategies. Furthermore, our findings underscore the significance of immature neutrophils in the progression of COVID-19 in patients with cancer, advocating for further investigation into how these cells contribute to both cancer and COVID-19 disease.
Ajuts:	Instituto de Salud Carlos III PI21/01653 Instituto de Salud Carlos III PI22/01017
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; IL-6 ; Cancer ; Dnlr ; Neutrophils
Publicat a:	Cancers, Vol. 16 Núm. 17 (september 2024) , p. 2974, ISSN 2072-6694

DOI: 10.3390/cancers16172974
PMID: 39272832

19 p, 2.5 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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