Relevance of TMPRSS2, CD163/CD206, and CD33 in clinical severity stratification of COVID-19.

Background: Approximately 13.8% and 6.1% of coronavirus disease 2019 (COVID-19) patients require hospitalization and sometimes intensive care unit (ICU) admission, respectively. There is no biomarker to predict which of these patients will develop an aggressive stage that we could improve their quality of life and healthcare management. Our main goal is to include new markers for the classification of COVID-19 patients. Methods: Two tubes of peripheral blood were collected from a total of 66 (n = 34 mild and n = 32 severe) samples (mean age 52 years). Cytometry analysis was performed using a 15-parameter panel included in the Maxpar® Human Monocyte/Macrophage Phenotyping Panel Kit. Cytometry by time-of-flight mass spectrometry (CyTOF) panel was performed in combination with genetic analysis using TaqMan® probes for ACE2 (rs2285666), MX1 (rs469390), and TMPRSS2 (rs2070788) variants. GemStone™ and OMIQ software were used for cytometry analysis. Results: The frequency of CD163+/CD206- population of transitional monocytes (T-Mo) was decreased in the mild group compared to that of the severe one, while T-Mo CD163-/CD206- were increased in the mild group compared to that of the severe one. In addition, we also found differences in CD11b expression in CD14dim monocytes in the severe group, with decreased levels in the female group (p = 0.0412). When comparing mild and severe disease, we also found that CD45- [p = 0.014; odds ratio (OR) = 0.286, 95% CI 0.104-0.787] and CD14dim/CD33+ (p = 0.014; OR = 0.286, 95% CI 0.104-0.787) monocytes were the best options as biomarkers to discriminate between these patient groups. CD33 was also indicated as a good biomarker for patient stratification by the analysis of GemStone™ software. Among genetic markers, we found that G carriers of TMPRSS2 (rs2070788) have an increased risk (p = 0.02; OR = 3.37, 95% CI 1.18-9.60) of severe COVID-19 compared to those with A/A genotype. This strength is further increased when combined with CD45-, T-Mo CD163+/CD206-, and C14dim/CD33+. Conclusions: Here, we report the interesting role of TMPRSS2, CD45-, CD163/CD206, and CD33 in COVID-19 aggressiveness. This strength is reinforced for aggressiveness biomarkers when TMPRSS2 and CD45-, TMPRSS2 and CD163/CD206, and TMPRSS2 and CD14dim/CD33+ are combined.

[Study of migratory grief in immigrant patients seen in primary care clinics. Presentation of a migratory grief evaluation questionnaire]. / Estudio del duelo migratorio en pacientes inmigrantes que acuden a las consultas de atención primaria. Presentación de un cuestionario de valoración del duelo migratorio.

OBJECTIVES: To validate a questionnaire designed to show the existence of migratory grief (MG) and its dimensions in the immigrant population, and to study its relationship with certain sociodemographic variables. DESIGN: A descriptive, cross-sectional, multicentre study. EMPLACEMENT: Consultations in Primary Health Care. PATIENTS: The study included 290 Primary Health Care immigrant patients over 18-years old. There were 12 rejections due to, lack of time, absence of a translator, and lack of understanding. PRINCIPAL MEASUREMENTS: An MG questionnaire with 17 questions was employed, carrying out a factor analysis with final extraction of 4 factors explaining 52.1% of overall variance. Sociodemographic variables were collected: gender, age, marital status, nationality, social network, time in Spain, legal and work situation and communication difficulties. Multivariate analysis was performed using the sociodemographic variables. RESULTS: Four factors were found (fear, homesickness, concern and loss of identity), showing that non-communality was < 0.30 and considering that the 4 factors represent the group of variables from the questionnaire. After analysing the correlations between the different factors, it was observed that concern is related to fear and homesickness, this latter being independent from fear. The loss of identity had a low correlation with other factors. Cronbach's alpha showed good consistency in factors 1, 2 and 3. Some sociodemographic variables are associated with the presence of each factor. CONCLUSIONS: We present a validated instrument to study and characterise MG, adapted to study the different dimensions of the grief in immigrant population.