Macrophage Migration Inhibitory Factor (MIF) Plasma Concentration in Critically Ill COVID-19 Patients: A Prospective Observational Study
Christian Bleilevens, Josefin Soppert, Adrian Hoffmann, Thomas Breuer, Jürgen Bernhagen, Lukas Martin, Lara Stiehler, Gernot Marx, Michael Dreher, Christian Stoppe, Tim-Philipp Simon, Christian Bleilevens, Josefin Soppert, Adrian Hoffmann, Thomas Breuer, Jürgen Bernhagen, Lukas Martin, Lara Stiehler, Gernot Marx, Michael Dreher, Christian Stoppe, Tim-Philipp Simon
Abstract
Mortality in critically ill coronavirus disease 2019 (COVID-19) patients is high and pharmacological treatment strategies remain limited. Early-stage predictive biomarkers are needed to identify patients with a high risk of severe clinical courses and to stratify treatment strategies. Macrophage migration inhibitory factor (MIF) was previously described as a potential predictor for the outcome of critically ill patients and for acute respiratory distress syndrome (ARDS), a hallmark of severe COVID-19 disease. This prospective observational study evaluates the predictive potential of MIF for the clinical outcome after severe COVID-19 infection. Plasma MIF concentrations were measured in 36 mechanically ventilated COVID-19 patients over three days after intensive care unit (ICU) admission. Increased compared to decreased MIF was significantly associated with aggravated organ function and a significantly lower 28-day survival (sequential organ failure assessment (SOFA) score; 8.2 ± 4.5 to 14.3 ± 3, p = 0.009 vs. 8.9 ± 1.9 to 12 ± 2, p = 0.296; survival: 56% vs. 93%; p = 0.003). Arterial hypertension was the predominant comorbidity in 85% of patients with increasing MIF concentrations (vs. decreasing MIF: 39%; p = 0.015). Without reaching significance, more patients with decreasing MIF were able to improve their ARDS status (p = 0.142). The identified association between an early MIF response, aggravation of organ function and 28-day survival may open future perspectives for biomarker-based diagnostic approaches for ICU management of COVID-19 patients.
Keywords: COVID-19; Horowitz Quotient; ICU treatment; Macrophage Migration Inhibitory Factor (MIF); SOFA Score; acute respiratory distress syndrome (ARDS).
Conflict of interest statement
The authors declare no conflict of interest.
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References
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