• Int. J. Clin. Pract. · Nov 2021

    Randomized Controlled Trial

    Assessment of severity and mortality of COVID-19 with anti-A1 and B IgM isohemagglutinins, a reflection of the innate immune status.

    • Fatih Ozcelik, Alpaslan Tanoglu, Bulent Barıs Guven, Umran Keskin, and Mustafa Kaplan.
    • Department of Medical Biochemistry, University of Health Sciences Turkey, Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
    • Int. J. Clin. Pract. 2021 Nov 1; 75 (11): e14624.

    AimsThe relationship between the innate immune system that creates the polysaccharide antibody response and COVID-19 is not fully understood. In this study, it was aimed to determine the predictive values of isohaemagglutinins in COVID-19 severity/mortality.MethodsApproximately 15 440 patients diagnosed with COVID-19 were examined, and a total of 286 patients with anti-B and anti-A1 IgM isohaemagglutinins test results were randomly enrolled in the study. These patients were stratified into two groups according to anti-A1 (n: 138 blood type B or O) and anti-B (n: 148 blood type A) IgM isohaemagglutinins. Anti-A1 or/and anti-B IgM, biochemical parameters, symptoms, chronic diseases, hospitalisation status, intubation status, admission to intensive care unit (ICU) and exitus status were recorded and evaluated for all patients.ResultsAnti-A1 IgM and anti-B IgM were significantly lower in ICU patients (7.5 ± 9.9 vs 18.0 ± 20.4 and 5.5 ± 6.3 vs 19.3 ± 33.6 titres, respectively; P < .01) and in exitus patients (3.8 ± 3.6 vs 16.7 ± 18.7 and 3.5 ± 4.7 vs 16.9 ± 29.6 titres respectively; P < .01). In the ROC analysis performed to differentiate between exitus and discharge within groups, the sensitivity of anti-B IgM and anti-A1 IgM at cut-off ≤4 was 88.9% and 79.6%, specificity 66.0% and 73.4%, and AUC 0.831 and 0.861, respectively (P < .01). Anti-A1 IgM decreased the mortality risk 0.811 times per unit while anti-B IgM decreased 0.717 times (P < .01).ConclusionAnti-B and anti-A1 isohaemagglutinins, which are an expression of the innate immune system, can be used to predict the severity and mortality of COVID-19 disease.© 2021 John Wiley & Sons Ltd.

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