{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:53:09Z","timestamp":1790977989542,"version":"4.1.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Purpose:<\/jats:title>\n Differentiating bacterial sepsis (BS), severe coronavirus disease of 2019 (SCOV-19), and noninfectious systemic inflammatory response syndrome (SIRS) remains challenging due to overlapping clinical features. We evaluated the diagnostic and prognostic utility of neutrophil CD64 (nCD64), Monocyte human leukocyte antigen-DR (mHLA-DR), and the immune dysregulation index (IDI) across these conditions.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n In this prospective observational study, 150 intensive care unit (ICU) patients were enrolled: BS (\n n<\/jats:italic>\n = 44), SCOV-19 (\n n<\/jats:italic>\n = 46), SIRS (\n n<\/jats:italic>\n = 30), and healthy controls (\n n<\/jats:italic>\n = 30). Flow cytometric quantification of nCD64 and mHLA-DR was performed, and IDI was calculated as (nCD64\/mHLA-DR) \u00d7100. Clinical, laboratory, and outcome data were analyzed to assess group differences and diagnostic performance.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n nCD64 expression was significantly elevated in sepsis (median 2310 antibody bound per cell) compared with SCOV-19 (931), SIRS (1034), and controls (348;\n P<\/jats:italic>\n = 0.001). mHLA-DR was suppressed in sepsis and SCOV-19 (2711 and 2522) relative to SIRS (10,113) and controls (14,950;\n P<\/jats:italic>\n = 0.031). IDI was highest in sepsis (84.16), intermediate in SCOV-19 (38.4), lower in SIRS (9.8), and minimal in controls (2.1;\n P<\/jats:italic>\n < 0.0001). IDI demonstrated excellent discrimination between disease and controls (area under the curve [AUC] = 1.0), sepsis and SIRS (AUC = 0.96), and moderate discrimination between sepsis and SCOV-19 (AUC = 0.75). Higher IDI values were associated with mortality in both sepsis (107.80 vs. 35.00;\n P<\/jats:italic>\n = 0.032) and SCOV-19 (73.02 vs. 19.80;\n P<\/jats:italic>\n < 0.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Immune phenotyping using nCD64, mHLA-DR, and IDI effectively differentiates infectious from sterile inflammation and predicts mortality, supporting its integration into ICU risk stratification.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aam.aam_198_26","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:00:25Z","timestamp":1790974825000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Neutrophil CD64, Monocyte HLA-DR, and Immune Dysregulation Index as Biomarkers for Severe Coronavirus Disease of 2019 Infection, Bacterial Sepsis, and Other Systemic Inflammatory States"],"prefix":"10.4103","author":[{"given":"Namrata Punit","family":"Awasthi","sequence":"first","affiliation":[{"name":"Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridhar","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, King George Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravin Kumar","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumya Sankar","family":"Nath","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,14]]},"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_198_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:00:36Z","timestamp":1790974836000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_198_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/aam.aam_198_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]},"assertion":[{"value":"2026-02-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}