{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T07:22:48Z","timestamp":1775546568714,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Because one-third of patients deteriorate after their admission to the emergency department, assessing the prognosis of COVID-19 patients is of great importance. However, to date, only lymphopenia and the partial pressure of oxygen\/fraction of inspired oxygen (PaO2\/FiO2) ratio have been reported as partly predictive of COVID-19\u2013related further deterioration, and their association has not been evaluated. We asked whether other key biomarkers of SARS-CoV-2 immunologic defects\u2014increase in circulating immature granulocytes, loss of monocyte HLA-DR (mHLA-DR) expression, and monocyte differentiation blockade\u2014could also predict further COVID-19 deterioration. A series of 284 consecutive COVID-19 patients, with the sole inclusion criterion of being an adult, were prospectively enrolled at emergency department admission (day 0) of 2 different hospitals: 1 for the exploratory cohort (180 patients) and 1 for the confirmatory cohort (104 patients). Deterioration was assessed over the next 7 days. Neither increased immature granulocyte levels nor monocyte differentiation blockade predicted patient worsening. Among more than 30 clinical, biological, and radiological parameters, the value of decreased P\/F ratio and lymphopenia for prediction of further COVID-19 deterioration was strongly confirmed, and the loss of mHLA-DR was the only additional independent marker. Combined together in a simple OxyLymphoMono score, the 3 variables perfectly predicted patients who did not worsen and correctly predicted worsening in 59% of cases. By highlighting lymphocyte and monocyte defects as preceding COVID-19 deterioration, these results point on early immunosuppression in COVID-19 deterioration. Combining P\/F ratio, lymphopenia, and loss of mHLA-DR together in a simple and robust score could offer a pragmatic method for COVID-19 patient stratification.<\/jats:p>","DOI":"10.1093\/jleuko\/qiae022","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T06:04:50Z","timestamp":1708149890000},"page":"1131-1142","source":"Crossref","is-referenced-by-count":3,"title":["Along with PaO2\/FiO2 ratio and lymphopenia, low HLA-DR monocytes are the only additional parameter that independently predicts the clinical course of undifferentiated SARS-CoV-2 patients in emergency departments"],"prefix":"10.1093","volume":"115","author":[{"given":"Thomas","family":"Lafon","sequence":"first","affiliation":[{"name":"Emergency Department, University Hospital Center of Limoges , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Centre d\u2019Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Chapuis","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1016, Centre National de la Recherche Scientifique Unit\u00e9 Mixte de Recherche 8104, Institut Cochin, Universit\u00e9 Paris Cit\u00e9 , 27 Rue du Faubourg Saint-Jacques, 75014 Paris , France"},{"name":"Service d'H\u00e9matologie Biologique, H\u00f4pital Cochin, Assistance Publique\u2013H\u00f4pitaux de Paris, Centre-Universit\u00e9 Paris Cit\u00e9 , 27 Rue du Faubourg Saint-Jacques, 75014 Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estelle","family":"Guerin","sequence":"additional","affiliation":[{"name":"Laboratoire d'H\u00e9matologie Biologique, Centre Hospitalier Universitaire de Limoges , Centre de Biologie et de Recherche en Sant\u00e9, rue Bernard Descottes, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Daix","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Centre d\u2019Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"R\u00e9animation Polyvalente, Centre Hospitalier Universitaire de Limoges , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Unit\u00e9 Mixte de Recherche 1092, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcela","family":"Otranto","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital Center of Limoges , 2 avenue Martin Luther King, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Boumediene","sequence":"additional","affiliation":[{"name":"Laboratoire Immunologie, Centre Hospitalier Universitaire de Limoges , Centre de Biologie et de Recherche en Sant\u00e9, rue Bernard Descottes, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Jeannet","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Centre d\u2019Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"Unit\u00e9 Mixte de Recherche Centre National de Recherche Scientifique 7276\/Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1262, Contr\u00f4le de la R\u00e9ponse Immune B et Lymphoprolif\u00e9rations, Centre de Biologie et de Recherche en Sant\u00e9 , rue Bernard Descottes, 87025 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Fontenay","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1016, Centre National de la Recherche Scientifique Unit\u00e9 Mixte de Recherche 8104, Institut Cochin, Universit\u00e9 Paris Cit\u00e9 , 27 Rue du Faubourg Saint-Jacques, 75014 Paris , France"},{"name":"Service d'H\u00e9matologie Biologique, H\u00f4pital Cochin, Assistance Publique\u2013H\u00f4pitaux de Paris, Centre-Universit\u00e9 Paris Cit\u00e9 , 27 Rue du Faubourg Saint-Jacques, 75014 Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karam","family":"Henri Hani","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital Center of Limoges , 2 avenue Martin Luther King, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Vignon","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Centre d\u2019Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"R\u00e9animation Polyvalente, Centre Hospitalier Universitaire de Limoges , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Unit\u00e9 Mixte de Recherche 1092, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9961-5739","authenticated-orcid":false,"given":"Guillaume","family":"Monneret","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019Immunologie, H\u00f4pital E. Herriot, Hospices Civils de Lyon , 5 Pl. d'Arsonval, 69003 Lyon , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Fran\u00e7ois","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Centre d\u2019Investigation Clinique 1435, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"R\u00e9animation Polyvalente, Centre Hospitalier Universitaire de Limoges , 2 avenue Martin Luther King, 87042 Limoges , France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Unit\u00e9 Mixte de Recherche 1092, Centre Hospitalier Universitaire Dupuytren , 2 avenue Martin Luther King, 87042 Limoges , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jais","family":"Jean-Philippe","sequence":"additional","affiliation":[{"name":"Imagine Institute, Universit\u00e9 Paris Cit\u00e9 , 24 Bd du Montparnasse, 75015 Paris , France"},{"name":"Biostatistic Unit, Necker University Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris , 149 rue de S\u00e8vre, 75015 Paris , France"},{"name":"Human Genetics of Infectious Diseases: Complex Predisposition, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale Unit\u00e9 Mixte de Recherche 1163 , 24 Bd du Montparnasse, 75015 Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6223-2454","authenticated-orcid":false,"given":"Jean","family":"Feuillard","sequence":"additional","affiliation":[{"name":"Laboratoire d'H\u00e9matologie Biologique, Centre Hospitalier Universitaire de Limoges , Centre de Biologie et de Recherche en Sant\u00e9, rue Bernard Descottes, 87042 Limoges , France"},{"name":"Unit\u00e9 Mixte de Recherche Centre National de Recherche Scientifique 7276\/Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1262, Contr\u00f4le de la R\u00e9ponse 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